Homestead_Hardiman (17) •
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}".. CLAIM FOR HOMESTEAD PROPERTY TAX F I L y j 1) YEAR
r• 'P- STANDARD/SUPPLEMENTAL DEDUCTION FORM
s State Form 5473(R12 16-09) HC10
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s Prescribed by the Department of Local Government Finance MAR 18 2013
INSTRUCTIONS:See reverse side for filing instructions. 4 .i
CERTIFICATION St=3IiMdtlI
I(We) ,t,1 In- .t cI. Mitt a A► . certify that I(we)occupied as my(our)principal
place of residence .0 re)buying the following described real property for which a Homestead Property Tax Standard Deduction is hereby claimed
under contract on the e this application is filed, (date of filing):
_..)S1I(We)own ❑ Am(are)buying under recorded contract
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❑ 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
Name of claimant(legal name) '
Core\
Name of claimant's spouse(legal name)
Sodal Seaalty number of claimant's spouse(last five digts)I Drivers license/Identification/Other number Issuing State
of claimant's spouse(last five digits)
CONTRACT RECORDED
11 buying on contract,Fee Simple owners name
Recorders office where contract is recorded I Record number Page
PROPERTY DESCRIPTION
County Township Taxing district( ' kyet amass )� T��,�py/L�
a ti Parcel number Legal description Is the property in question: /
7—_I jJr" JO- 757 p�3 Real property ❑Annuaty assessed mobile home(IC 6-1.1-7)
0 any portion of the residential structure or the land not''exceeding one(1)acre that Immediately'sudotatdss that structure is used to produce Income,describe the use and portion
of the property utilized to produce income.
• a &- /i - 0 7 - aoo Q co 7 9 - oa -7
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County Township
I hereby certify the above statements are true,correct and complete.
• .PL. art.. s.
Address(number and street,city,state,and ZIP code) I
S'S ' r • ri .... . •. .act N A ,: - 0
ASSESSOR USE ONLY I TRUE TAX VALUE I AAT 100%OF TTVE I HO VALUE AD I NON- VALUENTIAL
Land not exceeding 1(one)acre Immediately q rrr> art, ,.p purr +s;.;
surrounding residential improvements. (1) -s:S. "..- `3 rasr � '1L;s-°
Other land (2) • iy ~L
Total land(line 1 plus line 2) (3)
Dwelling :-.3. -S• vc -
Residendal Improvements or Annually -
Assessed Mobile I Manufactured Home Garage ^';4Ig �, r;`=°.-x;- �j^}' :.�rXs't
(5) f,;iwxiSCt'].'+� '~•x•3` wryb.
Nriot.' W
Other Improvements (6) '::S'v 4 _a3. !
Total Improvements(line 4 through line 6) (7) ,
Total value (line 3 phc line 7) (8)
I hereby certify the above is true,correct, Signature of Assas.nr Data signed(month,day,year)
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 real property or to a manufactured home that is not assessed as reel property may not exceed
one-half(12)of the assessed value of the mobile home or manufactured home.
Signature of Auditor Date signed(month.day,year)