Homestead_Schwartzlose CLAIM FOR HOMESTEAD PROPERTY TAXFJL E `t i YEAR
`{� STANDARD /SUPPLEMENTAL DEDUCTION FORM
7 '., !.' State Form 5473(R12/6-09) :.i C10
1 w I. Prescribed by the Department of Local Govemment Finance 'DEC l•.1 8 2012 l_ i r 1
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INSTRUCTIONS:See reverse side for filing instructions.
��I /� CERTIFICATIO;:ET:,^c;Ac1 Ft
® I(We) 4 T/Z�/f�Q'`///Z�LLro/ _ certify that I twah as my(our)principal
place of re- '- ce or am(are)buying the following described >Jf.roperty for which a Homestead Property GIBB Tai Standard Dedu n hereby claimed
under co ,n ct on the date this application is filed, - (date of firing):
ON COUNTY AUDITOR
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
CONTRACT RECORDED
If buying on contract Fee Simple owners name
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Recorders office where contract is recorded Record number Page
' PROPERTY DESCRIPTION
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County �' Township TaxagL.` �tnw'ruprpJ\ /
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Pa •- r�� Legal description Is the roperty in question:/1
Real property ❑ Mnually assessed motile home(IC 6-1.1-1
® If any port' r 1 he residential structure or the and not exceeding one(1)aaa that Immediately su d6 Nat 6WClure 19 used to produce Income,desaae the use end portion
of the pm hf¢ed a rotluce- in/me.
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• a6 -6' --A? do3-l/ov,�.3o- 4�U
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County Township County Township •
I hereby certify the above statements are true,correct and complete. ,Sgna •i dolman• 9
e
Address(number and street,rill:state,and ZIP code) �° / a L 'Q / ea %/ /i /
�/JI V Yj ^TA I AREI:ESSED VALUE I HOMESTEAD NON-RESIDENTIAL
ASSESSOR USE ONLY I TRUE TAX VALUE AT 100°h OF TTV I VALUE VALUE
Land not exceeding 1(one)acre Immediately S' 'a4='w2x' +i `ti`� a-
surrounding residential improvements. (1) .4,9a,..�° =a-�h`-;7 flail
Other land (2) '-?•���p{•g;
Total land(line 1 plus line 2) (3)
tt e��`Ir* H 4 4c—=
Dwelling (4) '' °(k max r_
Residential Improvements or Annually - .h*. - � ?C9x3$. �,:
Assessed Mobile I Manufactured Home - 'e + .7ksW`'' ' SGara e
Other Improvements (6) 'MN=
Total improvements(line 4 through line 6) (7) - •
Total value (line 3 plus line 7) (8)
I hereby certify the above is true,correct, Signature of Assessor Date 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 accessed as real poperfy or to a manufactured home that is not assessed as real property may not exceed .. _ -
one-al/(12)of the assessed value of the mobile home or manufactured home.
Signature of Auditor Date signed(month,day,year) '
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