HomeMy WebLinkAboutHomestead_Stafford (2) f:4,S CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
.`, STANDARD /SUPPLEMENTAL DEDUCTION 1 r M !
•-• '` State Form 5473(R12/6-09) . _ _ ,C10 i ilk
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'ate J Prescribed by the Department of Local Goverment Finance JJI e _
INSTRUCTIONS:See reverse side for filing instructions. - APR 1.6 2013
CERTIFICATION STATEMENT
fir:�_ j�-
I(We) - ' �-i - / " Gl c., g : . j' ''.. , as my(our)principal
place of residence or am(a.. ' •g the following described real prope �o ich a Homestead Property Tax Sta .a . rraierroliqtreby claimed
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under contract on the date s application is filed, (date of filing):
❑ I(We)own ❑ Am(am)buying under recorded contract
❑ Am(am)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
Na SIname)
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Name of claimant's spouse(legal name)
Social Security number of claimant's spouse(last five digits) Driver's license I Identification/Other number Issuing State
of claimant's spouse(last five digits)
CONTRACT RECORDED •
If buying on contract,Fee Simple owner's name • '
Recorder's office where contract is recorded Record number Page
PROPERTY DESCRIPTION
• County Township Taring district(city,town,tomowwnship)
Parcel number Leg escriptan' ///�� ip (�� Is the property in question:
'--s-•>� /��� T ( ❑Real property Annually assessed mobile home(IC 6-1.1-7)
If any portion of the residential structure or the land not exceeding one(1)ace that Immediately surrounds that structure is used to produce income,desaae the use and portion
of the properly/utilized to produce income.
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PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County Township County - Township
I hereby certify the above statements are true,correct and complete. �reture of dai
Q(VC6krNUYA3545-A
Address(number and street,city,state,and ZIP code)
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ASSESSOR USE ONLY - TRUE TAX VALUE I ASSESSED VALUE I HOMESTEAD I NON-RESIDENTIAL
AT 100%OF TTV VALUE VALUE
Land not exceeding 1(one)acre Immediately ` "',,,. r ±° •ri
surrounding residential improvements._ (1) = ,- x.�? 4 2r' �" .-.
Other land (2) .IS `. .
Total land(line 1 plus line 2) (3)
Dwelling (4) 't`G ? %Ex< '-'arx'E7-
Residential Improvements or Annually , ` Y �,`
Assessed Mobile I Manufactured Home
Garage ( )
Other Improvements (6) ' ,T ;
Total Improvements(line 4 through line 6) (7)
Total value (line 3 pits line 7) (8) •
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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 deductions provided in IC 6-1.1-12 to a mobile home that is $
not assessed as reel property or to a manufactured home that is not assessed as real property may not exceed
one-half(1/2)of the assessed value of the mobile home or manufactured home.
Sig ire of Auditor •
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Data signed(month,day,year) f
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