Homestead_Pinkston (3) Ar CLAIM FOR HOMESTEAD TAX
C9STANDARD/SUPPLEMENTAL EE UCT ON FORM YEAR
State Fe 5473(8161 5-14) HOW
by the Dept-anent of Local Government Finance
INSTRUCTIONS:See reverse side for fling instructions.
NOTE:Telephone,Social Security,drivers license,state identification and federal identification numbers are confidential under IC 6-1.1-12-37.
I(We) 7%ci72a S L. //fin] her ll i n KS ton certify that I(we)octal s y( r)pn ;;!,,1 ' I i
place of residence or am(are)buying the following de bed real property under contract for which a Homes ro rty
- Deduction is hereby claimed on the date this application is signed, I�
y pp g (date mat ):
JC}tOwn. ❑ Am(are)buying under recorded contract NOV c �Oc
CI Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation. 'V y O U
r ❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified personal residence trust .
❑ Am(are)the shareholder, partner, or member of the entity that owns the property.
4_,li
- -:••
Ute rip on contact Fee Simple onmis name
Readers oboe where ported is recorded I Read minter 1 Page .
- `44..:>.4i. "Yt ieROPERTY DESCRIP.TIONt . .�'--`IT-?
•County Township ITang Essig(dly.tour, ')_ lJ /s
Parcel number Legal desaiptien `/IIIIIsss the property in question: /hull
.a./4-0.3',w crn d 94 eb27 ,aweal PppeltY ❑ Annually assured noble home(fc 61.1-7)
tf any portion of the restdenial stucare cc the lad not exceedeg one(1)acre that immediately surrounds that Humus is used to produce'umme,describe the use and portion
of the tams to Trod a itne./
y2f � e 5e Ja/o i?. 0 77
- _ - " - PROPERTY OWNED ELSEWHERE BY CLAIMANT _ '
Sate,Coney.and Towwep Is claimant vacating a homestead?
. ' ❑ Yes ❑ No
Signature of damam
I hereby certify the above statements are true,correct,and complete.
r M1INN by /
Address of contact(number and tree,ay stare,and ZIP i Address of vacated homestead,d any(number end sleet,coy,state,end ZIP cede)
759 7J• 3so L- . eiru2k:fr 14J47(a 0•ASSESSOR USE ONLY - ',I ASSESSED VALUE • ,HOMESTEAD VALUE H ri NON-RESIDENTIAL'VALUE
land not exceeding one(1)acre Immediately (1)
- - '= =c' --
surrounding resid ential Improvements --- -- -- -- —�--
Other land (2)
Total land(line f plus line 2) I(3) - I - - — - - -
Residential improvements or Dwelling I(4) 74F
Annually Assessed Mobile l
Manufactured Home Garage (5)
Other Improvements 1(6) = .;ES ' c
Total improvements(line 4 through line 6) I(7)
Total value (line 3 phs line 7) I(8)
I hereby certify the above Is true,correct, I Signature of Assessor Dare signed(mwh.day,year)
and complete.
Veify'ug action•Signature ofAaib Date signed((Dora day,year)
i;- - „-rey._bra's� S , _WSTANDARODEDUCTIONALLOWANCE �y e }mot,._ .--a" _- ,7:7-_ -
20 pay 20 Lasser of 60%of the assessed value of the homestead or$45,000
Notuithstanding any other provision,the sum of the deductions provided in IC 6-1.1-1 2 toe mobile home $
that is not assessed as real property or toe manufactured home that is not assessed as real property may
not exceed one-half pivot the assessed value of the noble home or manufactured home.
Signature of Audtor Data signed(rant%day,year)
DISTRIBUTION:Odmal-Gouty Nxfar,Fie-Stamped Copy-Tagvyer
..•�•..
v�/"=" � CLAIM FOR HOMESTEAD PROPERTY TAX
i��'= CREDIT/STANDARD DEDUCTION
,�;.��� State Form 5473 (R2 / 5-92)
�a� . .
INSTRUCTIONS: See �everse side tor /iling instructions.
FORM
HC10
� �;—` ' �
YEAR
a_� ����__ �v_p�irvLV�_�� r-- � !/�l.C£�(ff}-th3ton;he7stYdayofMarch,t9t
) occupied as our principal place of residence the following described real property f r w ich a�HOmesi - Property�x.CPBtlN�eby claimed:
❑ I We owned - . �
O ❑ nre buying under contract �. _ AUD�TOR
❑ Have a beneficial interest in ihe entity thai is liable for the property taxes on the property and ihat owns the property or is buying under a contraci.
� . � CONTRACTRECORDED�
IIf buying on contrati. Fee Simple ownefs name � ' � - . '
Recortler's oHice where contract is recorded Record number Page
Counry
� PROPERTY DESCRIPTION
Township . Taxing disuici (ciry, town: township)
Legal description
/J-e-�. 3-a—
or the IaM not exceedirg one (7) acre Nat immediatey wrrounds that strucmre is used to
describe [he use antl portion
�
� PROPERTY OWNED BY CLAIMANT IN OTHER COUMIES �
CAUniy Township Caunty Township
\
�:eby certify the above statements are irue, correct and complete. Signawre t claimant
�,� e.��:.�.a.�.
Adtlress (numberantl street ciry, sfafe, ZlPpode)
(Z2�Z �ox 3�F� A
ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not exceeding 1(one) acre immediately
surrounding residential improvemenis. ��)
Oiherland (p) -
Total land (line 7 plus line 2� (3)
Dwelling (4)
Residential improvements
Garage (5� � �
Other improvements - (6)
Total improvemenis (line 4 fhrough lina � (7)
Total value (line 3 p6s line � (g)
I hereby certify [he above i5 Irue, corretl. and Signature of Assessor Date signed
complete.
irg action � Sgna;ure ot Autlitor Date sfgnetl
19_Pay79_
Lesser of 1/2 Homesiead
Valuation or S2,000
STANDARD DEDUCTION ALLOWANCE
S
oi Autlitor � Date signed