Homestead_AlbersCLAIM FOR HOMESTEAD PROPERTY TAX
STANDARD / SUPPLEMENTAL DEDUCTION
State Form 5673 (8131 12-09)
4N
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
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APR 13 2012
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��CERTIF
►- W �Occtupted as '
place of residence oram (are)&ying the following described real properyfor which a Homestead Property Tax Slatg%opegl"" Wgo��
.
ler Own
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
■ Am (are) the shareholder, partner or member of the entity that owns the property.
Other
of claimant's sIxxtse (last live digits)
��TT �•a;,y`. �1 r -a-2 �s t a : �z � r 3nitzs t 'ri- CONTRACTSRECORDEO' re s i s`? -:� r�_ ?Yr_R ,tv - _� s �i -. >t ,:.�,
t1..�:tir +Si. i,. i.-s, ."%i.<a Y.- Ca<>�s• %i � tS�z:- �Sr..e- f3.,i -f. ..k�'+.�. ��?�'+5 s..bF�_= cZ .r,i- z.L.:r..
If buying on contract. Fee Simple cwr�ees name
•,= 'rst.Y:
'a ..ss' .. .a- ."Y..-�P.ROPE0,`' ESCRIPTION,'i
� � ►fib
_,1 �rl _ � a ..a:
at - _
,?i.ay '!PROPERTY OWNED :BY,CLAIMANT,'IN O -THER' COUNTIES ,.",
I hereby certify correct
t�
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IWOMW&MOUT.Wal ,v i i
v'?kt'1rFs;Y'ASSE OR USE ONLYh'"r,.('t"baY�'i +bla
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i�ASSESSED VALUE'.I�°'
:AT�tU9- jj.aaT_.V-
HOMESTEAD- �i,
)NON_ RESIDENTIAL(
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Land not exceeding I (one) acne immediately
sumounding residential
Total land (fine I plus fine 2)
_
Residential Impro"ments or Annualty
AssessedlijlobflalMannu&�facturvd am
Total improvements (fine 4 through flne 6)
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I hereby certify the above Is true, correct,
..
and complete.
y?. js'R�;•.,etc�`�}yL'idy�:o...3�. ,."? „: rr= �„ Y! �:,'- 5: 3,. Y:. �tiSTANDARD: DEDUCTIONALLOWANCE��e ,.t.>F?`} >�w, .k�a., ?, .t�'.<.�"a, �'Te `' - ..;..'s
r pay 20 60% of the assessed value o the hmestead or $45.000
NotwithstandkV any otherprovision, the sum of the deducticom provided in IC 6-1-1-12 to a mobse home thatis
not assessed as rest praperty or to a mamdscrured home that is not assessed as real property my not exceed
one-haff (112) of 0a assessed vahm of the mobile home or manufactured h�.