HomeMy WebLinkAboutHomestead_ByeCLAIM FOR HOMESTEAD PROPERTY TAX
STANDARD if SUPPLEMENTAL DEDUCTION
0 Sate Forth 5473 (R12/6-09)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for fling instructions.
FORM YEAR
IGR
I (N/e) certify that I ( pled as my (our) principal
place of re i nce or am (are) buying th Ilovdng described real property for which a Homestead Property Tax Stand rd Qg1:U 1d�j�greby claimed
under contract on the date this application is filed, (date of filing): GIB$Q^I C/
COUNTY
I (We) o Am (are) buying under recorded contract
vm El A(J (JI -TOn
tgAm (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.
Name of d�ftanl (legal game)
UnAZUE
Soda) rnmiher of damrant last fire
Drivers license / Identificetion /
Name of claimant's spouse (legal name)
Social Security number of claimant's spouse (Issf five digits)
Drivers license / Identification / Other number
Issuing Sate
of claimant's spouse (last five dlgiis)
CONTRACT ••. .
If buying on contract Fee Simple owners name
Recorders office where contract is recorded Record number Page
PROPERTY DESCRIPTION
Ceunry / � � _, \
u�
Township Taxirg ' ldd (' tun, 1 ip) r
Parcel number
p, fion
Is ropeny in question:
19 ,%
1777//) / / — '•'--
Real property ❑ Annually assessed molter home (IC 6.1.1 -7)
any of Ne residential struceire o the and not exceeding one (1) tads that immediately sort d that structure is used to produce income• describe theme and portion
®If
of Ne p ny utilized to produce income.
l0i- 000.471a -007
PROPERTY OWNED BY
County Township County Township
I hereby certify the above statements are true, correct and complete.
Sig ture of claimant
Addre gs (nurnt and street, city, state and LP code)
/n �o
ASSESSOR USE ONLY TRUE TAX VALUE ASSESSED VALUE I HOMESTEAD NON-RESIDENTIAL
I AT 100% OF TTV I VALUE VALUE
Land
e)roeimmediatety (1) y� ws vII
surrounding reds ti( _
� v
Other land
(2)
Total land (fine 1 plus line 2)
(3)
Dwelling
(4)
� `-V`r
':...Nk F3•3 ytC� lYS
Residential improvements or Annually
Garage
(5)
4 "'°"•�'n -"' '' °-
Assessed Mobile I Manufactured Home
:eat z. -t .sm^".f.yy.,jt�"
Other improvements
(6)
x4.f.?2
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(8)
1 hereby certify the above is true, correct,
Signatum of Assessor
Data 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
Notwithstanding any other provision, the sum of the deductions provided in IC 61.1 -12 to a mobile home that is
5
not assessed as real property or to a manufactured home that is not assessed as real pmperry may rot exceed
-- - -
one- hal(12) of the assessed value of the mobile home or manufactured home.
Signature of Auditor -
Date signed (month, day, year)