HomeMy WebLinkAboutHomestead_Lankford (10)_ �
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CLAIM FOR HOMESTEAD PROPERTY T
_ STANDARD / SUPPLEMENTAL DEDUCTION FE� 5 2��3
State Form 5473 (R12 f 6-09)
�,� � Prescribed by the DepaRment of Local Govemment Finance
n.
. A�pii'�R
lNSTRUCTIONS: See reverse side for filing instnictions.
FORM
HC10
YEAR
I(We) � certify that I(we) occupied as my (our) principal
place of residence or a(are) buying the foll ing described real property for which a Homestead Property Tax Standard Deduction is hereby claimed
under contract on the date this application is filed, (date of filing):
�I (We) own ❑ Am (are) buying under recorded contract
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 Vust
Name of daimant (legel name)
Social Securily number of daimaM (last fiire dig�s) Drivers i'icense / Identification / Ofher
��� of daimant (last five digiGs)
Name of daimanYs spouse (legal name)
Social Security number of claimanYs spouse (last five digits) Drivers license I Iden6fication / Other number
of claimarrt's spouse (last fire digits)
H buying on contract, Fee Simpie ovmers name
Recorder's otfice where conVad is recorded
Issuing State
Issuing State
Record number Page
County Tovmship Taxing district (' to�n townshiP)
Parcel number Legal descripGon Is the property in question:
. Real property ❑ Mnually assessed mobi�e home (IC 6-1.1-�
H any por[ion of Me residendal sWcture or the land not exceeding one (t ) aae that immediately surto ds at sWcture is used to produce inoome, describe the use and portion
of the property utilized to produce income.
al�-Ia-�-�- aC� l-�G �'� l G��
County
Township
I hereby ceRify the above statements are true, cortect and complete.
(number and sfreet city, s�etate, and co¢e)
D3 N �ZAGC J'� . �� � ��
Land not exeeeding 1(one) acre immediately
Other land
Total land (line 1 plus line �
Dwelling
Residential improvemenfs or Annually
Assessed Mobile / Manufactured Home Garage
Other improvements
Total improvements (llne � through line 6)
Total value (Ilne 3 plus line 7►
I he�by certify the above is true, correct,
and completc.
V¢ri(ying adion - Signature ofAudiWr
N
County
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(3)
(4)
t5)
(6)
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Signature of Assessor
Township
Date sfgned (month, day, yea�
Date signed (month, day, year)
20 pay 20 Lesser of 60% of the assessed value of the homestead or $45,000 �(�
��
Nohyithstanding any other piovisJon, the sum of the deductions pmvided in IC 6-1.1-12 to a mobfle home that is $ �M��
.,,.. e���� n� ,o.,i mm�n.fv or m a manufactured home that is not assessed as real p�operty maY not exceed