HomeMy WebLinkAboutHomestead_HerresCLAIM FOR HOMESTEAD PROPERTY TAX
STANDARD If SUPPLEMENTAL DEDUCTION
State Fomn 5473 (R1216-09)
S Presuihed by the Department of Loral Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
FORM YEAR
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I (We) r ify that 1 (we) occupied as my (our) principal
place of residence or am (are) buying the following described real prop or which a Homestead Property Tax Stand clionis hereby claimed
under contract on the date this application is filed, (dale of filing): O /BSON
COUNTY
❑ 1 (We) own ❑ Am (are) buying under recorded contract
AUDITOR
❑ 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 personal residence trust
INFORMATION
CONTRACT ••s r
If buying on contract, Fee Simple owners name
Recorders office where contrect is recorded Record number Page
PROPERTY DESCRIPTION
CCXJ ^ Township
Taxing district (city, town, to i
p Vberr ,On4�(r� I• Legaldescription
6
Is a
mmrty in question:
TLH 8
Real property ❑ Annually assessed mobile home (IC 51.1 -7)
If any portion of the residential suuctura or the land not exceeding one (1) acre that immediately surrotmAs that sWcNre is used to produce income, describe the use and portion
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of the property udraed to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County Township County Townshp
I hereby certify the above statements are true, correct and complete.
Signature of claimant A
NIQ o�U
Ad ss (number and street, cay, state, and ZIPcode)
12 -479' E. /oo S, a RkLA7j-p CITr r� 14 0
ASSESSED VALUE r r
TRUE TAX VALUE
ASSESSOR USE ONLY AT 100% OF V
Land not exceeding 1 (one) acre immediately Sg°rYsr
surrounding residential im rovements. O - --k'
.a ns
Other land
(2)
ryce °s s.
Total land (line 1 plus line 2)
(3)
Dwelling
4
'•`` 1 S �va� F
'
Residential improvements or Annually
Assessed Mobile I Manufactured Home
Garage
- ^.A�Y
•r�-� `yam S4
(5)
,Y,� ¢�,n- .y,��'j���t,
Other improvements
(6)
Total Improvements (line 4 through line 61
(7)
Total value (line 3 plus line 7)
(8)
1 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)
STANDARD • r
20 pay 20 Lesser of 60% of the assessed value of the homestead or $45,000
Notwtimtanding any other provision, the sum of the deductions provided in IC 51.1 -12 to a mobile home that is
5
rot assessed as real property or to a manulacrumd home Nat is not assessed as real property may not exceed
one -hall (12) of the assessed vahre of the mobile home or manufactured home.
I Auditor
Data sign (month .
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