Homestead_Alvis (4) °"�a CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR _
4.— - A STANDARD / SUPPLEMENTAL DEDUCTION HCto
C Z.
State Form 5473(R13/12-09)
,.I� Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for filing instructions.
- CERTIFICATION STATEMENT ,, %,-
I(We) e ',, . certify , I( :. .'' - )principal
place of residence or am(are)buying the following descried 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). I(We): MAY 16 2013
❑ Own ❑ Am(are)buying under recorded contract
❑ Am (are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation ' - y xi
pg�s pt7� �t �MPT IPI
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified l 1i tlJV�el. z,-,ffini' .UDITOR
❑ Am (are)the shareholder, partner or member of the entity that owns the property.
. - _ , -ss r :. . . -c 'ic CLAIMANTpS;INFORMATION , x.. - .ac. °
Name aimant(legal name)
aa-e__ Lp e--) a.9
Name o irnant's spouse(legal name) r ,v�a---,
r:
If buying on contract,Fee Simple owner's name
Recorder's office where contract is recorded Record number I Page
- • i.- PROPERTY DESCRIPTION .__
County Township Taxiiist-4--4 -
Parcel number Legal devscription Is the property in question:
� y 9 /91- ❑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)acre that immediately surrounds that structure is used to produce income,describe the use and portion
of the property utilized to produce income.
2CO-1a — o7 - y03 - OOO. 09 / - 01. 8
• - PROPERTtI'OWNED.BY CLAIMANT IN OTHER COUNTIES_- - - -.,-
County Township County Township .
I hereby certify the above statements are true,correct and complete. Signatu ofd am .
1 Address(number and street,city state,and ZIP code) +
N � .�✓ ;70
ASSESSOR USE ONLY;_ TRUE TAX VALUE I ASSESSED VALUE HOMESTEAD NON-RESIDENTIAL
-- _ °� AT::100%OFTTV -I HO-VALUE I VALUE.
Land not exceeding 1(one)acre Immediately
surrounding residential improvements. (1)
Other land (2)
Total land(line 1 plus line 2) (3)
Dwelling (4)
Residential improvements or Annually
Assessed Mobile/Manufactured Home Garage (5)
Other improvements (6)
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.
Verifying action-Signature of Auditor Date signed(month,day,year)
' STANDARD DEDUCTION ALLOWANCE II. -
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 pmperfy 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.
Signature of ,r2 Date signed(month,day,year) '