Homestead_Bye (2)ddSCLAIM FOR HOMESTEAD PROPERTY TAX
STANDARD / SUPPLEMENTAL DEDUCTION
oNA11 State Fonn 5473 (R12 / 6-09)
°k Presuihed by the Department of Local Govemment Finance
INSTRUCTIONS: See reverse side for filing instructions.
\
IA J
{ '•
NMI
ME )
OCT 0 2 2009
•
ha1l
I(We) certify t]It1 (��.��1�°��7.�0(9)(BFNdpal
place of residence am (a e) buying the f wing described real property for which a Homestead Property Tax Standard Deduction is hereby claimed
under contract on the dale this application is (led, (date of filing):
I (We) own ❑ Am (are) buying under recorded contract
Am (are) entitled to occupy as a tenant - stockholder of a coopera9ve 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 claimant (legal name)
Soda) Seoaby norther
Recorders office where contrail is recorded Record number Page
PROPERTY DESCRIPTION'
Ceunry
Taxing
Township g i istdct (city, town, township) D.
Parcel
Legal description
Is a property don:
l �� \� _� ^ Q
OD
1 property ❑ Annually assessed mobile home (IC 6f.7 -7)
If any portion of the residential structure or the land not exceeding one (1) acre that immediately sunounds that structure is used W produce income, describe the use and portion
of the property utilized W produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County Township County Township
I hereby certify the above statements are true, correct and complete.
Signawre of claimant -
v
ress (number and street, dry; state, and ZJPcada
/Q 1�L Z 76 Z a
S o ST
NON-RESIDENTIAL
HOMESTEAD ASSESSOR USE ONLY- TRUE TAX VALUE ASSESSEDVALUEJ I AT IGO% OF TTV VALUE VALUE
Land not exceeding 1 (one) acre Immediately
(1)-
surrounding residential improvements. -=
�p -
RN!,
J°''_
Other land
(2)
-'.s:
Total land (line 7 plus line 2)
(3)
Dwelling
(4)
Residential Improvements or Annually
Assessed Mobile I Manufactured Home'
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(6)
I hereby certify the above is true, correct,
Signature of Assessor
Date signed (month, day, year)
and complete.
Verifying action - Signawre of Auditor Data signed (month, day, year)
STANDARD
20 _ pay 20 Lesser of 60% of the assessed value of the homestead or $45,000
Notwithstanding any otherprovision, the sum of the deductions provided in IC 6-1.1-12 to a mobile home that is $
m: assessed as real property cr to a manufactured home that is not assessed as reat property may not exceed
one -hatl (712) of the assessed value of the mobile home or manuradured home.
Signawre iron
Data signed (rtronth, day, yea
1