HomeMy WebLinkAboutHomestead_Bates (7)CLAIM FOR HOMESTEAD PROPERTY TAX
__ t STANDARD/SUPPLEMENTAL DEDUCTION
State Fartn 5473 (R73I 12-09)
� yw � Presmbed by Ihe Department of La�l Govemment Finaxe
INSTRUCTIONS: See ieverse slde for fiGng ins6uGions.
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1(We1 �cr�..�_��c"� certifythatlgii9�R101A9P19�Fp1[�PI��
place ut residence or am (are) buyirg the folbwing described real propeRy fw whi�h a Homestead Property Tax Sfandard Deduction is hereby daimed
�er contract on ihe date this appliration is filed, (date of filing). I(We):
Own ❑ Am (are) buying under recorded contract
� Am (are) entl0ed to occupy as a tenan[-srockhoider of a cooperative housing mrporaGon
❑ Have a benefidal interest in ihe Wst or Ne right to ocwpy the property under the terms ot a qualified personal residence Wst .
❑ Am (are) ihe shareholder, partner or member of the entity Ihat owns ihe property.
Legal desulption
I r�.G��`/ �'� � 3<
If any poM1ion of Me asidenUal structure or the IaM not exceedinB�ana (1) acre U�at imm�
U Iha D�rtY uti0zed ta p�oduce Inmma.
�-�a-o�-�o�_000. iia-va-�
Twrtiship
I hereby certify Me ehove statements are We, correG and complete.
Lantl not ezueamg 7(orre� acre unme
surroundi� residenUal Improvements
Other land
Total land (lirte 1 plus lirre 1)
Residential improvements or Annuaiy
Assesaed Mobile / Manu(ac4�red Home
Other Improvements
...,.., ��)
(Z)
(3)
Dwellln9 (4)
Garaga (5)
(6)
Totnl Improvemerrts (line 1 Nrough line �
7ota1 value (tine J pl�s Ilne �
I hereby certify the above Is We, correct, I�"a01e
and complete.
Veritying aWon - Sigrrature W NWimr
Reoord numhel
Taring distrid
Page
the pmperly in puestion:
� ❑ Real pro{�erty � AnnuaOy assec5ed mob0e home (IC 67.1-.
surtwnds ihat strutlure is used to produce income, desaibe the use aM pwtion
_ pay 20 _ Lesser of 60% of the essessed vdlue of the homastead or $45,000
NoMiMStanding any oMerprovisbn, the sum W tlm deducfiorrs provded in IC 61.1-f2 ta e rmW7e home Mat a
not essessed es real propeM or ro e manNactured home Nat is rat essessed as mel pioperty may not exmed
ene-hntl /121 W Me �.c ���Ne W Me rtaW7e home or manulactuied home.
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$
Township
Dafe signeC (mon(h. deY• Y��)
Date signed (monlh. daY• Y��
Date signed (month, day,
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