Homestead_Angle CLAIM FOR HOMESTEAD PROPERTY TAX - - • YEAR':t.-'r.' STANDARD / SUPPLEMENTAL DEDUCTION FORM
'< State Fonn 5473(R13/12-09) HC10
''? Presented by the Department of Local Goverment Finance
1 II 1 'JCTIONS See reverse side for filing instructions. E I
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� ':ai '!�:F,I�f.CERTIF.ICATION:STATEMENT;hi.'t'xeri._ 1hir , i r.._4_•i °}..�.-+-e
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I(We) inslarInfr�...- certify that 1I(we)occupied as my(our)principal
place of resld]..- or am(are)buying the following .'��.bed real property for which a Homestead Propgl7fiatln2 42Deduction is hereby claimed
under contract on the date this application is filed, (date of filing). I(We):
A C.J. V
Own ❑ Am(are)buying under recorded centred
Am (are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation n clef.N COUNTY AUDITOR
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified personal residence trust •
❑ Am (are)the shareholder, partner or member of the entity that owns the property.
yizrtf.A " ,..C^=•.r.`4it:,a6-T' ,..,`ter LrT R,',a7 ,:,*t a rAIMANi SINF,ORMATION,:r:''.cta ..11:ttt-r 2 a >?• Z:j' Z.,:Fi.s.Ys:a i°i
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If buying on contract,Fee Simple owner's name
Recorder's office where contract is recorded - Record number Page
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�'�.4...__tr.F �: "Ty�„`i:f PROPERTYsDE$CRIP.TION.. �„Z,�, ,let e<.x 5:�.-+Y,(-•i�as..C;�t;L'*s,.� ,.C-�.^.'�-
Township T:., . . . e(dfy,town,township)
1t ML..� n
r-.../el number Legal description Is`thhee g_mperty in question:
to-!.3 —/QI -a0�i- 0 s o (W/ 00(5- USJ Real property ❑ Annually assessed mobile home(IC 61.1-n
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,desate the use and portion
of the property utilized to produce Income.
.it titFr:fi<e'.'-.i-.._,_ 2 nI`art A"Y) kPROPERTY,OWNEiSiBYl,CLAIMANT IN OTHEkC'OUNTIES�ts.,Tiu,iwx.fir F.f;.y,k`',tglQ Ts;lc
County Township County Township
I hereby certify the above statements are true,correct nd complete. S'•nature of claimant
d •
Add K (number and street,city,state,and ZIP code)
103 - a • c,ev • a • OX • ;6q Y'G 1 SC_o ( 17(41-l9
n ,l -" $ e ASSESSOR USE ONLY L < e TRUEaTAx YACUErLASSESSED VALUE'I-t X kVA UEAD,.r�'-' .kc*tNON yRE51DENTIAL 44
sniff igti n . ., ... ._.. ,.1•Y>..: .a'`b istI t'l:M.-, _AT_100 to OF.+T,TVat(rxY n>3VALUEas,.._.�d� ?.. .n+y:+:eVALUE:'t .-tc. i. '
Land not exceeding 1(one)acre immediately -n"T<``; ' 'ti 'e-E '4
surrounding residential Improvements. (1) AV vc-fr 3 - -:.r
Other land (2) 'fir r 'o . sN
Total land(fine 1 plus line 2) (3)
Residential Improvements or Annually
Dwelling (4) art acs' -x"i,LLN,sF" ;,,wj .
Assessed Mobile/Manufactured Home w 'S' ' -=si'x-� ;r Garage (6) r< . iW .". :
Other Improvements (6) ; ,e4r 4_4 a
Total improvements(line 4 through line 6) (7)
value (line 3 plus linen (6) --
I hereby certify the above is true,correct, Signature of Assessor Data signed(month.day,year)
and complete.
Verifying action-Signature of Auditor Date signed(month,day,year)
''i f;'T �1MF t i°Y? -.' < g 1`" `!y�.yysq .=STANDARD:DEOUCTION"ALLOWANCEC;, ` i.n4'.ac + 3- _ i.* --
ay�1T. . a .2. c P.... x w•L.^r.�fi. -.+...♦�u}Y,Z1,y�.�:-_. ,. .. . .l _ S-.W.,. '� .ue?'.^i�.'nrn1.��'>��4�v_u..-_. ]-e
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 m 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 real properly may not exceed _ /
one-halt(1,2)of the assessed value of the mobile home or manufactured home. _ -- - I (''uI
Signature of Auditor Date signed(month..day,year).
.