HomeMy WebLinkAboutHomestead_Dowdy (2)"'" CLAIM FOR HOMESTEAD PROPERTY TAX ����� FORM YEAR
� STANDARD / SUPPLEMENTAL DEDUCTION � �
is� � S��FO���3cR,2��> FEB 2.6 2013 ►,c,o
Prewi6ed by lhe Departrtrent of Loml Gavemme�ri Frence
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INS7RUCT10NS: See reverse si�de for fJGg inshucfions. `�
I(We) ' cer�iy lhat I(we) ocwpied as my (our) prindpal
place of residence or am (are) 'ng the following described real roperty for which a Homestead Property 7ax Slandard Deduction is hereby daimed
untler conVact on the date Ihis ap inGOn i5 filed, (dafe ol filing):
�I(We) own ❑ Am (are) buying under recorded conVact
Am (are) enlilled lo occupy as a tenant-stockholder of a cooperative housing corporation
� Have a benefidal interest in ihe Wst or the right to occupy the properry under the tertns of a qualified personal residence Wst
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Name o( da'unant (kgal nama)
—i�nn
Sodal SequiH narbcr o( dae�mnl (65 fi�e dg�) Orivers fcenva / IdmNration / Othr! num�
Name o(daimaM's 5pouu (lepelneme)
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Sodal Security numbv ot dalmanfs spouse (las( fiva tlig'45) Orivefs tirense / Identifiration / Olher mimber Issuing State
of daimarrt's sPase (last five dg'ris)
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If buyvig am m�trac� Fee Simple ownefs eume
ReoorOefs oR¢e where mnVed'u remtleE Recdd number Pa9e
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counry ramshio ra�g aisu;a (ci�: ro»n, �ownsn�v)
ParcnJ number Legal drsuiptian Is �he P Derty in Question:
' Real yoperty ❑ MnuaDy assessed mobile home (IC Sf.7-7)
I( anY PoNm U the 2sdential strucwre or Ne IaM nol ewzetlGg me (1) aae Nat immediately wrtou 9 Uld� Sb11L91I8 �S IISBd IO pfOdULO �(IWff10. dBSClIbB i�lE Y58 211d POIil0I1
or me w�aem w�a m�a� �c«�.
a�-��-zo-z��� 98�-oa1
... . . : . .
Counry Township Caunry � Tovmship
I hereby cenify the above stetements are We, cortect and complete. S� ol d.i �
Address (numDer and sheet, ciry, sfete, entl LPootla)
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land not ezceeding 1(one) acre Immediatety � '-y�,tty��3 ���`.s"s'�,�' ��;�
surtoundin residential im rovements. � � �..-- �'��:. � v- �. C..r�`.
Otherlantl � - 2 �`i�4�`»���
� ) :��.'�'s''_�,�.2Y`7:
7ota1 land (line 1 plus line � (3)
�. a�= .�_.' : '.'�`n.
Resltlentlal Impmvements orMnualty ����ng (4) - �'�^�S`�-.� ���� �
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Assessed Mobile / Manufacfured Home Gare e ���'�� '�••F -� �*'�4
9 �5) E:. .r,L^. _t . v� _'c°�`.'�. �Si�k�':�
�}�,,Y-",• ''i�y=:F�T'
Other improveme� � is) � � :%e'::�'•�u�+��'`��s .��-_'-''-�
Tofal Improvemenb (Ilne 0 NrougAline � (7)
To41 value (firre 3 phs Ilna � (8)
I hereby certify the above is We, wmect, Sig�mre otASSessor Date WgneE (manlh, day, yeer)
and complete.
Vaifyi�g ac4on - 519naNre o1 PuClw bate signed (monN. daY• Y��
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20 _ pay 20 Lesser of 60% of the assessed vAue o� Ne homestead or $45,000
NoMi(hsfarN'ug any aGrer provison. Ne sumW Lre tleduUiwu provided in IC 67.1-12 to a mo6l7e fartre Nat is $
mt essessetl as real property or fo e manNacfured hort�e Nat'a rpt essessed es real property mey no! exceed
oneJ�aX (72) W Ne assessed ve/ueW the rtabile hwne ar manNaGUred Aome.
Sigfuture of Pudrtor Date siBneO (monN, daY. Y�� �