Homestead_Sensmeier (2) f_Pi CLAIM FOR HOMESTEAD PROPERTY TAX F YEAR
- STANDARD/SUPPLEMENTAL DEDUCTION
State Fonn 5473(R12/6-09) �( e`
S // Prescribed by the Department of Loral Government Finance v pJpA`
INSTRUCTIONS:See reverse side for filing instructions. - O ek fit\
CERTIFICATION STATEMENT
(W ) .IPLIW 1!/" / • i t�.•r
I e I1/ / i. I OW_ /IL I_ • certify - I • - iJ &a�g1Y.lour)principal
place of residence or am(are) following property Property �/•- it�
under contract on the date this application is lfi described real ro for. a Homestead P- N 6'
y don is hereby claimed
application (date of filing): • c�Q
Rid(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 trust
CLAIMANT'S INFORMATION
If buying on contract Fee Simple owners name
•
Recorders office where contract is recorded Record number Page
PROPERTY DESCRIPTION
County Township Taxing district(city,town,to '
Parcel number Legal desaippuiae Is the in question: �•Y v
`-'r L?/ Real property El Annually assessed mobile home(IC 61.1-7)
If any portion of the residential structure or the land not exceeding one(1)acre that immediately surrounds that structure Is used to produce income,desanbe the use and portion
of the property utilized to produce income.
- 6.-aO -0 o /MO 00 a. 0 07 -6or /
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County Township County Township
•
I hereby certify the above statements are true,correct and complete. Sig claimant
•••ress(number and street,a1y,state,and ZIP code)
4I E 'ais kr : : • , cY . - 6 • ;
I ASSESSED VALUE HOMESTEAD I NON-RESIDENTIAL '
ASSESSOR USE ONLY I TRUE TAX VALUE I AT 100%OF TN VALUE VALUE
Land not exceeding 1(one)acre Immediately ' €d -s"vi'ixSe
surrounding residential improvements. (1) - '"s _ rF=-ie:5-rs.='
Other land (2) 'rit '
Total land(line 1 plus line 2) (3) - -�- - - --
Residential Improvements or Annually Dwelling (4) �'�` ^`,rc' - r
Ass ced Mobile I Manufactured Home Garage (5) r -}`Fz " T? 4'
Other Improvements (6) � b at
•
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-Signature of motor Date signed(month,day,year)
STANDARD DEDUCTION ALLOWANCE
20 S pay 20 0 Lesser of 60%of the asenssed value of the homestead or$45,000 - .
NoMithstanndhg any•- - provision,the sum of the deductions provided in IC 6-1.1-12 to a mobile home that is $ '
not assessed as real property or to a manufactured home that is not assessed as real property may not exceed _ •
one-half(I/2)of the assessed value of the mobile home or manufactured home.
Sgt i� O�� any a o,