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Homestead_Montgomery r.} CLAIM FOR HOMESTEAD PROPERTY TAX } YEAR d STANDARD/ SUPPLEMENTAL DEDUCTION I I j,1 State Form 5473(R12/6-09) 4" . Prescribed by the Department of Local Government Finance MAY 5 2011 INS•tRUCTIONS:See reverse side for Ming instructions. C.3. '- o CERTIFICATION STATEMENT I(We) ! _ /�-ta_ s, -J real pro 2- for which a ' estead Property Tax Standard Deduction is hereby claimed under contract on the date this application is filed, _ (dal- •if fling): - ❑ I(We)own ❑ Am(are)buying under recorded contract ❑ Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation . ❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified personal residence trust CLAIMANT'S INFORMATION /. CONTRACT RECORDED If buying on contract.Fee Simple owner's name Recorder's office where contract is recorded Record number Page PROPERTY DESCRIPTION County Township Taxing dis • (city,town,township) Parcel number Legal description a. a.L/ A L Is the property in question: Pr E ME A-110 021- 01-7 ❑Real property ❑Annually assessed mobile home(IC 6-1.1-7) ® If any portion of the residential shucture or the land not exceeding one(1)acre that immediately surrounds that structure Is used to produce income,describe the use and portion of the property utilized to produce income. C L r I3 — a 9 - /0/- 00% 37 3 -009 . PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES County I Township County I Township I hereby certify the above statements are true,correct and complete. S of eta ,,t Add:(rynpbe� met, ,stet a ZIP code) 76 V5 • (l' )! ASSESSOR USE ONLY TRUE TAX VALUE I AAT E00%OF 71VE I HOVALUEAD I NON-RESIDENTIAL Land not exceeding 1(one)acre immediately 1 .' ,>.' r r.,:.;,,y*+�^�-' surrounding residential improvements. ( ) i°••,1'.••' -:GF'ic.., Other land (2) h.%FKM4 • Total land(line 1 plus line 2) (3) Residential improvements or Annually kit' xzs-` a; .7 Y _ Dwelling (4) A. V &$r 8.' '4$_xt. • Assessed Mobile/Manufactured Home P" 2ks n "' i%ti: Garage (5) 1",7fiaet;bi,>`esb' `'e� 52"✓. ' R Other Improvements (6) . ' � g1 Total Improvements(line 4 through line 6) (7) Total value (line 3 plus line 7) (8) I hereby certify the above is true,correct, Signature of A cassor Date signed(month,day,year) and complete. Verifying action-Signature of Aa6tor Date signed(month,day,year) STANDARD DEDUCTION ALLOWANCE ' 20 pay 20 Lesser of 60%of the assessed value of the homestead or$45,000 Notwithstanding any other provision,the sum of the deductions provided in IC 6-1.1-12 to a mobile home that is $ not n-coed as real property or to a manufactured home that is not assessed as reel property may not exceed one-half(fit)of the assessed value of the mobile home or manufactured home. Signature of Auditor Dale signed(month,day,year) ' C • 7- - INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 - D,PREPAR11E'R.; '!iQr4 LA. Lee l!,��f/. zow _/Yrr04�er / a/ Preparer of the Sales Disclosure Form� Title -- r3L IS 6iueev;llo Koi. frez(Number and Street)) E. SELLERS ` GRANTORS F.l «n A. MCIA wtPrJ Sellerl -Name as appeorson nveyanced current Seller 2- Name as appears on conveyance document 10 70 E. 700 S. Address (Number and Saeet) Address (Number and Street) F /r'id 1/7GGD Dak t"; )Y, -r,-y Telephone Number E -mail Under penalties of perjury, l hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct and complete as required by law, and is prepared in accordance with IC 6.1.1 -5.5, "Real Property Sales Disclosure Act ". Cz� P / o /� Signet of Seller Signature of Seller Printed Name o Seller Sign Date (MMIDD = Printed Name o Seller &n MM/DD/YYYYI F. BUYER SI GRAN^TAEE S,r = APPLICATION' FOR DEDUCTIONS' AND CREDITS - IDENTIFY ALL ITEMS THAT'APPLY j�<nrtt fk W '•'OAT4 ©MP /�/ G9 3� E a5o 5. Address (Number and Street) Address (Number and Street) �ranc i s o. =rl/ ® Telephone Number E-mail THE SALES DISCLOSURE FORM MAYBE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. YES NO CONDITION YES NO CONDITION X❑ ❑ 1. Will this property be the buyer's primary ❑x ❑ 3. Homestead residence? Provide complete address of primary ❑ Q 4. Solar Energy Heating /Cooling System residence, including county: ❑ ❑� S. Wind Power Device rnO1 �� E aso 5 ❑ ❑>t 6. Hydroelectric Power Device and Street) rr4ddress(Number I I ra111, 1SlD) =N 61769'9 6t6sv,1 ❑ ❑ 7, Geothermal Energy Heating /CoolingDevice E] $ Is this property a residential rental property? City. State ZIP Code Counry ❑ © 2 . Does the buyer have a homestead to be vacated for this residence? If yes, provide complete address of including / I I /� I /� O I , 3� 3 • p py 3y "'a9q V LJ residence vacating, county: %/ /a�tP•}��' Address(Numberand Street) Ci ,State ZlPCode �Iy Under penalties of perjury, I hereby certify that this Sales -J