Homestead_Stewart •
CLAIM FOR HOMESTEAD PROPERTY TAX i - i'1_
‘ STANDARD/ SUPPLEMENTAL DEDUCTION F:Rt •
" �'• State Form 5473(R12/609) HC70
S 7 % Prescribed by the Department of Local Government Finance 7. • I
INSTRUCTIONS:See reverse side for filing instructions. - ,r
CERTIFICATION STATEMENT -
I(We) ' -ii !- ►_ E - —. certify that I(we)occupied as my(our)principal
place of re t.ence or am(are)buying the foil/ g described real property for which a Homestead Property Tax Standard Deduction is hereby claimed
' - under contract on the date this application is fi -., (date of filing):
❑ I(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
Name f claimant(legal name) .x./
Social Security number of claimant's spouse(last five dgits)I Driver's license/Identification/Other number Issuing State
of claimant's spouse(last five digits)
CONTRACT RECORDED
fl buying on contract,Fee Simple owner's name
Recorders office where contract is recorded Record number Page
•
PROPERTY DESCRIPTION ty
County Township Taring• - '..(city wn,townssh�ipp)),- /��
Parcel number Legal desaip' G-Is the property in question:?
8 8 3 L )-0O A J ❑Real property ❑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,describe the use and portion
of the property utilized to produce income.
a6 - b5 - jai - 30o. - oor - 880 a7
- PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County Township County Township
I hereby certify the above statements are true,correct and complete. I -igna• re of claim t -
KAddress(num.•r and scree dfy,state, : •-code)
•f sal' .0 /.�`— . _ OF 47.770 t
ASSESSOR USE ONLY TRUE TAX VALUE I ASSESSED VALUE HOMESTEAD NON-RESIDENTIAL
AT 100%OF TTV VALUE I VALUE
Land not exceeding 1(one)acre Immediately tsi.va.y�7.
surrounding residential improvements. ( ) • a.e..teer =*S:x .-gi n
e ,F Other land (2) '3Vik -lana.
i -
Total land(line 1 plus line 2) • (3) •
Residential improvements or Annually Dwelling (4) —•-
Assessed Mobile I Manufactured Home i2a"^ y'T
Garage ( )
Other Improvements (6) .','J� ',ocr x.fi v
Total improvements(line 4 through line 6) (7)
Total value (line 3 plus line 7) (8)
hereby certify the above is true,correct, Signature of Assessor Date signed(month,day,year)
I and complete.
Veilybng action:Signature of Au6tor Date signed(month,day,year) .
STANDARD DEDUCTION ALLOWANCE
20 pay 20 Lesser of 60%of the assessed value of the homestead or$45,000
Notwithstandhg 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 properly or to a manufactured home that is not assessed as real pmpery may not exceed
one-hall(12)of the assessed value of the mobilile home eor�manufactured home.
Sig�f d'// 1 ,,ems' /yl:4. 6I , Data signed(month,day,year) .