Homestead_Rumble 1"x. CLAIM FOR HOMESTEAD PROPERTY TAX ui l a! I� YEAR
n` 1 .., STANDARD/SUPPLEMENTAL DEDUCTION S1
State Fonn 5473(R12/6-0g)
.-* .,-'/ Prescribed by the Department of Local Govemment Finance MAR 15 2013 '
INSTRUCTIONS:See reverse site for filing instructions. I • i- ._
CERTIFICATION STATEMENT
- • • e s DITOp I(We) A, 1 / 4�,L'r i
certify that I(we)occupied as my(our)principal
place of residence or am(are)buying the following 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):
X(We)own ❑ Am(are)buying under recorded contract
❑ Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation
0 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
Recorder's office where contract is recorded Record number Page
PROPERTY DESCRIPTION
Conn f Township Taxing district(city,town,township)
I/ ' a--)
Parcel number Legal description Is the p rty in question:
a Va property 0 Annually assessed mobile home(IC 6-1.1-7)portion If
of the property
�,¢�e�structure the land not exceeding one(1)acre that immediately surroun s t structure is used`to�produce income.dose to the use and portion
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County I Township County Township
I hereby certify the above statements are true,correct and complete. S' nature of imam' I
qd ss• Oar arWsueeG/� and'�= �`7i IS 09.51-a[t( � Al cf'7 f�39
I VALUE
(\ ASSESSOR USE ONLY I TRUE TAX VALUE I ASSESSED AT 100%OF TTV I HOMESTEAD AD I NON- VALIUENTIAL
Land not exceeding 1(one)acre immediately t tirdj e e1 s. n�sw,• z { 'Esurrounding residential improvements.
Other land (2) 4 :�:�`.,. 14
••
Total land(line 1 plus line 2) (3)
Residential Improvements or Annually Dwelling (4) ;= :' r *4nR
Accacced Mobile I Manufactured Home «^"�,,,3 S .s r ti
Garage (5) ��uA'� +���',..'�t�� `.
Other Improvements (6) - - ,,'��r`y,,y°,.xc�'1`; _
41Z
Total Improvements(line 4 through line 6) (7)
Total value (fine 3 pits line 7) (8)
I hereby certify the above is true,correct, Signature of Age-exert, Date signed(month,day,year)
and complete.
Verifying action-Signature of Auditor Date signed(month,day.Year)
STANDARD DEDUCTION ALLOWANCE
i
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 pmsted in IC 64.1-12 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(112)of the assessed value of the mobile home or manufactured home.
Signature of Auditor Data signed(month,day,Year)