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Home My WebLink AboutHomestead_Mitchell (9) "' CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR I :a._ --\ STANDARD I SUPPLEMENTAL DEDUCTION I State Form 5473(81515-14) HC10 Presail d by die Department of total Government Finance ' " INSTRUCTIONS:See reverse side for tiling instructions NOTE:Telephone,Serial Secunty,driver's license.state identification and federal identification numbers are confidential under IC 6-1.1-12-31 `- •- CERTIFICATION STATEMENT' - — -T•-- 7- In i //')T i/ 71-1 ® I(We) irI ig/lil�/GL certify that I(we)occupied as my(our)• 'W' place of residence or am(if buying the following described real property under contract for which a Homestead Property Tax r�Standard Deduction is hereby daim=•on the date this application is signed, (date of signature). I N�I.0 p Own. ❑ No(are)buying under recorded contract. ,��H 1 o 2O; ❑ 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 psly eaire -r; trust, ❑ Am(are)the shareholder, partner, or member of the entity that owns the property. ON L,. �jg .„ '. II buying on contact,Fee Semple owner's name Recorder's o5ce where comma is recorded Record number Page _ '._ s_ '_-:-.§ ._:� -a.-4PROPERTKDESCRIPTICN,; `>' �:cc v_ - Cm:im7 Township I Tazugown Parcel number Legal[QesmMon 'Is the pr petty in question: Z 7S. C3 / 120 �/Real property ❑Annually assessed mobile home(IC 6-1.14) It any cation of the residerdial sauaure or the land not exceeding one(1)acre that immediately Wsu/nour9a that structure is used to produce income,describe the use and porton of tie property weed to produce income. ® 0'4/a2 JP-070,2_oo4 2a3-oCz? PROPERTY OWNED ELSEWHERE BY CLAIMANT Satre,Corky,and Township Is claimant vacating a homestead? ❑ Yes ❑ No Signature of Wroara �/ I hereby certify the above statements are true,correct,and complete. £ �l^"�'��/~// Address of contact(number and street,oty,state,end ZIP code) Address of vacated ti6-iezesa,d any(number and street oy,Sate,and ZIP code) x /033 S. STogTSTf;cao., -Hv76wl ASSESSOR USE ONLY I ASSESSED VALUE I HOMESTEAD VALUE I NON-RESIDENTIAL Land not exceeding one(1)acre immediately I(1) surrounding residential improvements Other land I(2) Total land(line 1 plus line 2) 1(3) Residential Improvements or Dwelling 1(4) Annually Assessed Mobile I Manufactured Home Garage I(5) - Other improvements (6) Total improvements(line 0 through line 6) (7) Total value (line 3 pits line 7) (6) I hereby certify the above Is true,correct. Signature of Assessor Date signed(motet day,year) and complete. VeSyi g aabn-Signature of Nd:tor - Date signed(month,day,year) -r- 4r_;',g 17'" . — STANDARDDEDUCTION ALLOWANCE-'-cam--Sc "�?4 =-i1,"., • 20 pay 20 Lesser of 60%of the assessed value of the homestead or 545,000 Notnithstanding any other provision,the sum of the deductions provided in IC 6-1.1-12 to a mobile tome $ 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. Sig atae of Auditor Date signed(nowt.day,year) DISTRIBUTION:Original-County Aud::or,FLe-Stamped Copy-Taxpayer w�u.+ Hc io iem PreuriUeO By SWte BoarE ol Ta� Cammissioners To & FiIM in Duv��e CLAIM FOR HOMESTEAU PROPERTY TAX CAEDIT f0A YEAR 1912 �-, „ SEE BACK FOR FILING INSTRUCTIONS _, p Q� �" // — . K.��u,,,,,- !(We) ' certify that.on the 1st day of arch, 19 I, e) occu�d as our principal place o esidence the following described real property for which a Homestead Property Tax Credit is hereby being claimed: I, (We) �-owned ❑ are buying under contract ❑ have a beneficial inter�st in the taxpayer Property Description in ,�5.� 1 � M Taxing District (City, Town, Township): Parcel Number If buying on contract: Owners name �� simo�e owner� 0(9- c�1 ga3- �� nty �/� Township or legal description shown on tax statement: ,� Q�LoL � 7� Contract recorded in Recorders Office - Record No. Page If any portion of the residential structure 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 Any other counties in which individual owns or is buying real property: �hereby certify the above statement is true, correct and complete. i/) „--. � ��il i�4- -/J n i� __, c� n . . Shee� AOOress County Township State Individual either owns or is buying under a contract that provides he is to pay the property taxes on the residence, or has a beneficial interest in the taxpayer. - FOR ASSESSOR'S USE ONLY - Land not exceeding 1(one) acre immediately surrounding residential i�v�ent�-' � � Other Land Total Land Residential Improvements �� 2 � ��9 D II' we ing ge � � I Other Improvements AUDITOR T� Improvements - Line (6) plus (7) equals (8) I�by certify the above i�tru�ct�d co� �� Si9�wre oi nssesm� Approved True Cash Value (�) ��iO (2) �O—" �s� ',�� o (4) (5) (6) (�) (8) Assessed Valuation ��d .— o — /�o 70 Homestead Valuation 'j/�jj�jjjj j�jj/��j� �-�/-�9 Da�e _ � Date: