Homestead_WannCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (R817 -07)
Prescribed by the Department at Loral Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
FILEFORM J� YEAR
Cio YP'V
JUN j 5 2nno
(We) t� w N&AMZn n K/Q X�r�— ° � that on the 1st day of March, 20_
1 (We) occupied as our principal place of resilience described real property'�t�YQ*JC> t �laoertv Tex Credit is hereby claimed:
I (We) owned ❑ Are buying under contract uuRH
Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is buying under a contract.
CONTRACT • -. s
If !laying on contract, Fee Simple ownefs name
Recordefs offioe where contract is recorded Record number Page
County Township Terung district (city, town, township)
rod ber. Leg I dewy pli�pQy�) i� Is the property m question:
13 1 �.b(� VW 'f1 V "W I _ El Real property C3 Mobile Hama (IC E1.1 -n
If any portion of the residential structure or the land not exceeding one (1) acre that Immediately sumounds first suwwm i used to produce Indiana. describe the use and portion
of the property utilized to produce income.
o, a
5 _
FA
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ASSESSOR USE ONLY
TRUE TAX VALUE
PROPERTY OWNED BY
County Township
County Township
1 hereby certify the above statements are true, correct and complete.
Signature d ant a
,�,,"v�_ -�C• /1
= s (number and et city, state. arp ^cads) T��
5 _
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ASSESSOR USE ONLY
TRUE TAX VALUE
ASSESSED VAI UE
HOMESTEAD
NON
AT 100% OF TTV
VALUE
VALUE
Land not exceeding 1 (core) awe immediately
surrounding residential improvements.
i t
:. t°.-,I"x•
Other land
(2)
c
Total land (line 1 plus line 2)
(3)
Dwelling
g
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Residential improvements or Annually
Assessed Mobile I Manufactured Home
-
Garage
(5)
S
Other improvements
(6)
Total improvements (line 4 through fine 6)
(7)
Total value (line 3 plus 6ne 7)
(8)
1 hereby certify the above is true, correct, and
Signaure of Assessor
Date signed (month, day, year)
complete.
Verifying action - Signature of Auditor
Date signed (month, day. y "r)
STANDARD DEDUCTION
_ pay 20 — 45,000 for 2007 pay 2008 42,000 for 2010 pay 2011
Lesser of 12 44,000 for 2008
Homestead Valuation pay 2009 41,000 for 2011 pay 2012 §
or 43,000 for 2009 pay 2010 40,000 payable after 2012
Signature of Auditor pate igned ( y, y
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