HomeMy WebLinkAboutHomestead_Wilkas •
,,:.}:..:, CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
-,t STANDARD /SUPPLEMENTAL DEDUCTION
p _.t�. -'v State Form 5473(R12/609) HC70
.C.<,: ---.1 Prescribed by the Department of Local Govemment Finance _ -
INSTRUCTIONS:See reverse side for filing instructions • ; 1
r. I , a
s /1 CERTIFICATION STATEMENT _
I(We) A�rj /� 1 Y n�/ CCrrcertify that I(we)occupied as my(our)principal
place of residence or am(are)buying the following described real property for which a Homestead PrgE T4x-tli3rd Deduction is hereby claimed
under contract on the date this application is filed, (date of filing):
arL_ (We)own ❑ Am(are)buying under recorded contract /f ��� •
❑ Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporatipttCll�f )C'pl.1'r�"i�c"Yf'''µ9/M[
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms CCoP3quamleapeaflAt trust
CLAIMANT'S INFORMATION
Name of claimant(legal name)
Name of claimant's spouse(legal name)
Social Security number of claimant's spouse(last five digits) Drivels license/Identification/Other number Issuing State
of claimant's spouse(last five digits)
' CONTRACT RECORDED
If buying on contract,Fee Simple owners name
Recorders office where contract is recorded Record number Page
PROPERTY DESCRIPTION
�('/� County Township Taring district(city,town,township)
[% = -it ot—000 48avLa p v Its tO perry in question: ..
Real property ❑ Annuagy assessed mrWe lame(IC 61.1-7)
If any portion of the residential structure or the land not exceeding one(1)we that Immediately surrounds that structure is used to produce income,describe the use and portion
of the property utilized to produce income.
,oyittAttal adcP ay
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County Township County ' Township
c •
I hereby certify the above statements are true,correct and complete. Sign
att,/re of imam
U l�44n'O
Address(number and street,city,state,and ZIP code)
I
ASSESSOR USE ONLY TRUE TAX VALUE ASSESSED VALUE HOMESTEAD NON-RESIDENTIAL
AT 100%OF TTV VALUE VALUE
Land not exceeding 1 (one)acre Immediately �.,,, +,v;Y_:
surrounding residential improvements. (1) >E: .m +�3u' --3`-t
Other land (2) t :t'=t f�_*-4
• Total land(line 1 plus line 2) (3)
Residential improvements or Annually Dwelling (4) �§�v . *' r?
Assessed Mobile!Manufactured Home + .tit,- s f`
Garage (5) ff 1 3511. ." 9t; ' x
Other Improvements (6) h
Total improvements(line 4 through line 6) (7)
Total value (line 3 plus line 7) (8) •
hereby certify the above is true,correct, Signature of Assessor Date signed(month,day,year)
I and complete.
Verifying action-Signature of Auditor Date signed(month,day,year)
STANDARD DEDUCTION ALLOWANCE
20 pay 20 Lesser of 60%of the assessed value of the homestead or$45,000
Notwithstanding any other provision,the sum of the deduchbns provided in IC 6-1.1-12 to a mobile home that is 5'
not assessed as real properly or to a manufactured home that Is not assessed as real property may not exceed — - -
onehaIl(12)of the assessed value of the mobile borne or manufactured home.
Signature of Auditor Date signed(month,day,year)