Homestead_MaierCLAIM FOR HOMESTEAD PROPERTY TAX \�}-� �\� FORM �
ry� STANDARD / SUPPLEMENTAL DEDUCTION ✓ HC10
State Fortn 5473 (R13I 12-09)
� yw � P`espiEed by tha Department of loi�l Govemment Finarxe
INSTRUCTIONS: See reverse side Iar filing instructions. ��� ,��
I(We) �- `i�� certiry that I(we) ) Prindpai
place of idence or am (are) buying the follovring described real property fw which a Homestead Property Tau Sfandard D���e�y daimed
-der contract on ihe date this applintion is filed, (date o/filing). I(VJe): C'�.n _ V
pwn ❑ Am (are) buying under rewrded contract
Am (are) entitled to occupy as a tenant-stockholder of a woperative housing corporalion GIBSON COUNTY AUDITOR
❑ Have e benefiaal interest in ihe wst or the right to occupy the property under Ne terms of a qualified personal residence trust .
❑ Am (are) t1�e shareholder, pariner or member of Ne entity thal owns �he property.
RecoN numDet
rownshlA)
el poperty �,_J Annua�y assPSSM 1
SWCNre is used lo produce income, desc
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20 _ pay 20 _ Lesser ot 60% of the assessed value of the homestead or $45,000
Noh�itAsfendirg any Nherprovi5ion. Ne sum o(Iha deductims Wovidcd in IC 67. f-12 fo a mobile Mme Naf is $
not assessed es reel property a fo e menu/actured home that is nW essesmd as ieal property mey not expeeU
mo-h»tt If21 dthe n�m< �.+ �lue o/fhe moWe fartre w manWectured frome.
Tamship
Page
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Date s5ned (montA. tlaY. Y��)
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