Homestead_Wallace (2) CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
4._ % STANDARD /SUPPLEMENTAL DEDUCTION FORM
State Form 5473(R13/12-09)
*• ••� , • Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for filing instructions.
CERTIFICATION STATEMEENT _ °
I(We) \ •: x- 1�� I • L x//i�t rffet_ L certify th I o pie principal
place of residence am(are)buying the following described real property for which a Homestead Property Tax a ld d ed • •' '. y claimed
under contract on the date this application is filed, (date of filing). I(We):
rr it Own ID Am(are)buying under recorded contract SEP 062013
J Am (are) entitled to occupy as a tenant-stockholder of a cooperative housing corporation
IN Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified personal rgAidgnce rus
❑ Am(are)the shareholder, partner or member of the entity that owns the property.
_i. - .S _ fs" - _-"'-`iv:+cwr€721.7.. .z.:;:.-_-: ,.� ,�y,2.wti v t U Ptip- �.
�..'°-=�„�.y� -_� .y��� RCLAIMANT S�INFORMATION;`,- � _ .�- �.: �i-,xr__
five 6digits) -
_. :. _CONTRACT-:RECORDED-_ ' _ _ ,: -.a
If buying on contract,Fee Simple owner's name
Recorders office where contract is recorded Record number Page
,1
' .PROPERTY.DESCRIPTION
County Township 1 Taxin district(city,town,township)
Parcel number Legal description I Is1he property in question:
®Real property ❑ Annually assessed mobile home(IC 6-1.1-7)
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.
6 -1 3__J 8 - 'y 0 3 co d a o 5 co 5
-PR.ROPERTY,OWNED_BY CLAIMANT IN OTHER COUNTIES:,, - _ _. , _ _
County Township County ma/A��� /�� Township u
I hereby certify the above statements are true,correct and complete. Sign • roWCtX lvAR
Address(number and street,city,state,and ZIP code) -
ASSESSOR USE ONLY _ _-I TRUE TAX vALUE al-ASSESSED AAT 100°/OF--TTVEI-- HOMESTEAD-
I NON- VALUE
NTIAL
Land not exceeding 1(one)acre immediately
surrounding residential improvements. - (1)
Other land (2)
Total land(line 1 plus line 2) (3)
Residential improvements or Annually Dwelling (4)
Assessed Mobile I Manufactured Home Garage (5)
Other improvements ' (6)
Total improvements(line 4 through line 6) (7)
Total value (line 3 pits line 7) (8)
I hereby certify the above is true,correct, Signature of Assessor Date signed(month,day,year)
and complete.
Verifying action-Signature of Auditor Date signed(month,day,year)
- STAND_ARD_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 assessed as real property or to a manufactured home that is not assessed as real property may not exceed
one-half(1/2)of the assessed value of the more home or manufactured home.
Signature of Auditor ' Dat ed(m nth,day, °
CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDIT /STANDARD DEDUCTION Hc10
State Form 5473 (R614-03)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
I (We) I.C�C.+CR.L�.'� at 1 Wait March, 20
1 (We) occupied as our ri cipal place of residence the following described real property for which a om ad e red it is hereby claimed:
❑ I (We) owned ❑ Are buying under contract �b PR 16 2006
Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns roparty or is buying under a contract.
If buying on contact, Fee Simple owner's name
Recorder's office where contract is recorded
Record number I Page
= ,we= T sPRO P_ ERT Y D ESCRIPTIONr
County
Township
Taring district (city, town, township)
P�yel piyrrber_ O�O�
(lfv^ {/ r•/J�
Le e 'ption JT ^J I e property in question:
I (� t (Jig ❑ Real property '❑ Mobile Home (I.C. 6- 1.1 -7)
If any portion of the residential structure or the land not exceeding one (1) acre that immediat surtounds that structure is used to produce income, describe the use and portion
of the property utilized to produce income.
�r4;rt31.o�"`�?':':� = � _'��'°ss "•�"�QROP.ERTY.OWNED'BY CL'AIMANT<INOTHER" COUNTIESb ?''_;�.,__�•- ��r^„�,- .-- �?*��'.
County Township
Count Township
1 here y certify the above statements are true, cored and complete.
natu of claims t
ss in mDberand street dry, state, ZZiPcode)
pi"11
$ 3 ASSESSOR USE ONLY -x.--
-TRUETAXa� a
ltEVALUE
ASSESSED VALUE
+ HOMESTEAD g-
y
.." NONvRESIDENTIAIf�n
e ;,ii,•. ?�'.� u..__ir? n ..�4;: =� -, _ ,x .'�
iz`,�}�
!AT�100%.OFTTV�
�g---'WALUEss_ -,
c� t`VALUE •'m��,'. 1
...Y. _
Land not not exceeding 1 (one) acre immediately
surrounding residential improvements.
x
Other land _
(2)
z
t
Total land (line 1 plus line 2)
(3)
Dwelling
- -�'#
Residential improvements or Annually
(q).
Assessed Mobile I Manufactured Home
Garage
(6)
Other improvements
(6)
%1x�
•,fir t'
Trial improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(S)
1 hereby certify the above is true, cored, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
3w r r x- STANDARD'DEDUCTIONALLOWANCE,
Wr 20 _ Pay 20
Lesser of 112 Homestead
valuation or 535.000 $
Signature of Auditor Date signed