Homestead_Warren CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
-a�e \ STANDARD/SUPPLEMENTAL DEDUCTION HC10
State Form 5473(R15/5-14)
4Prescribed by the Department of Local Government Finance
. FORM
INSTRUCTIONS:See reverse side for filing instructions.
NOTE:Telephone.Social Security,driver's ' - se,state identification and(Semi identification numbers are confidential under IC 6-1.1 - 7. I l
/7 - �/ .SCE►RTIFICATION STATEMENT - f •-: - C --_e f f i- - -j
I(We) ' ���/L7% certify that I(we)oc upied as my(our)prinup-
place of re -r a•re)buying the following described real property under contract for which a Homestead Propertt ;1Standard
Deductim ereby ed on the date this application is signed, (date of signature). a 6a 2 -
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 quatfied res•- ?�Trh2 ei"
❑ Am(are)the shareholder, partner, or member of the entity that owns the property. •UN . r
zfr-. 1/'. . -CLAIMANV5INFORMATl0N:i.:./e -F,.;—'_t°*��TpR
t R.5 ?._CONTRACTRECORDED, -;3's, !S"_ _z; ^--• "c •;;-'y1:7.3C.
•If buying on contras Fee Simple owners name _ -
Recorder's o5ce where contract is recorded Record number Page
_�..,�,_-s:.�.�-211;51"-1 7,-. _ -. PROPERTY DEBCRIP7ICN)�`at�.-_.::'�'g.� r-ai-'- 1 ^y`.'�.
Coon �' ^/ ' Township- Taxing di d l(�. 1 fi t101.7'/ti1p) //�//Q_j/�
O, i Yom _`/ 'iY '.f-!!-//�J�
Parcel number eg / I Is the pr pasty in Question {r
t ,7 / i/ �p Heal property ❑ Annually assessed motile name(IC 61.1-i)
If any penal of the resuenual structure or the land not exceeding one(I)acre that . ately surrounds that s•.n Me is used to produce income,desaibe the use and portion
of the property utilized to produce income.
al -//-/6 e-6 . //Odd 9
PROPERTY OWNED ELSEWHERE BY CLAIMANT
Slaw,Courty,and Township Is claimant vacating a homestead?
❑ Yes ❑ No
sigfutu:7.r'aatsrt
I hereby certify the above statements are true,correct,and complete.
Address of contact(number and steel,My Sate,and ZIP code)
S..- :cat ead,d any(number and 5reet cry state,and ZIP code)/
U d^Jv, our DR
ASSESSOR USE ONLY I ASSESSED VALUE I HOMESTEAD VALUE I NONRrESISIDENTIAL
UE
ILand not exceeding one(1)acre immediately 11)
surrounding residential Improvements
Other land (2)
Total land(line 1 plus line 2) (3)
Residential Improvements or Dwelling (4)
Annually Assessed Mobile I
Manufactured Home Garage (5)
Other Improvements (6)
Total Improvements(line 4 through line 6) (7)
Total value (line 3 plus line 7) (6)
I hereby certify the above is W e,correct. Sgrature of Assessor I Date signed goon:*day year)
and complete.
Vady'rg adion-Signature of Tudor Date signed(month,day,year)
- rr r._.;. - -ti., «STANDARD.DEDUCTION ALLOWANCEr.. vriT-" .isr'�
20 pay 20 lesser of 60%of the assessed value of the homestead or 545,000
Notnithstanding any otherprmision,the sum of the deductions provided in IC 6-1.1-12 to a mobile home 5 .
that is not assessed as real property or to a manufactured home that is not assessed as real property may
not exceed one-half(12)of the assessed value of the mobile home or manufactured home.
Signature of Audlor Date signed(math.day year)
DISTRIBUTION: Ongiwl-Cotaty Auditor,Fie- amped Copy-Taxpayer
�'�°g CLAIM FOR HOMESTEAD PROPERTY TAX
s,��� CREDIT/STANDARD DEDUCTION
�;� State Form 5473 (R2 / 5-92) �
y��
INSTRUCTIONS: See reverse side lor /iling instructions.
.- �
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r�,yY ° 91995
�(We) . . certify that on the 1 st d�p[,�i��fiN�
,e) oc ied a ur principal place of resitlence the following described real pmperty for which a Homestead Property Tan Credit is hereby Gaimed:
I ( � ) owned ❑ Are buying under contract � . � . _ � .
❑ Have a beneficial interest in ihe entity that is liable for the property taxes on the property and that owns the property or is buying under a contract.
. . CONTRACT RECORDED ._ _ -
It buytng on contract, fee Simple owner's name � , . �
Recorder's office where contract is rewrdetl Recortl number Page .
PROPERTY
TownShip
Legal description
portion of the residential structure or the land not exceeding one (1) aae ihat immediately surwunds that strucmre is used to produce income, describe ihe use and ponion
property utilizetl to produce income.
PROPERTY OWNED BV ClA1MANT IN OTHER COUNTIES -
Caunty Township Counry Township
i
reby cenify the above statements are true, correct and complete. Sig wre ot imam
Ad reu (number and streeG ciry, state, ZIP code)
�/l l4 z rnlc�ron/s,�/ c' ? d
ASSESSOR USE ONLY . TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not exceeding 7(one) acre immediately
surrounding residentiai improvemen[s. (�)
Otherland (p) .
Total land (line 1 plus line 2� (3)
Dwelling (a) -
Residential improvements �
Garage (5) � '
Oiher improvements (6) �
Total impmvements (line 4 through lina � (7) ,
Total value (line 3 p6s line � (g)
I hereby Certify the above is lrUe, correct, and Sgnamre ot Asseswr Date signed
complete.
Verirying aaion - Signamre oi Autli;or Da;e signetl
J�
19_Pay79_
Lesser of 1/2 Homesiead
Valuation or 52,000
S
ALLOWANCE
Date signed