Homestead_Schmitt (21) a , CLAIM FOR HOMESTEAD PROPERTY TAX , FORM YEAR
— -:\ STANDARD /SUPPLEMENTAL DEDUCTION •
S -,r• State Form 5473(R-12/6-09) '3 1
‘ ,M d. Prescribed by the Department of Leal Govemment Finance 1 J FIL ; :�.
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INSTRUCTIONS:See reverse side for filing instnactions. DEC 1 0 20'
CERTIFICATION STATEMENT
I(We) t rrarati1'LS4e!y s�S(,'1 certify that I(we)occupied .s y •ur)principal
place of residence or am(are)buying the following described real O•-rly for which a Homestead Property Ta ggrgW DUUctign is h-•.,.y claimed
under contract on the date this application is filed, (date of filing): �)UIV UDITOR
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
If buying on contract,Fee Simple comers name
Recorders office where contract is recorded • Record number Page
PROPERTY DESCRIPTION
Coin se / / Township Tang q;q�id(rjy,town,township) •
Is Parcel number/yJ,� D 4-,0 U/f '(IIs the property on.
�i (' Real property ❑Annually assessed mobile home(IC 6-1.1-7)
II any portion of the residential structure or the land not exceeding one(1)acre that mungdia eN surrou s that structure is used to produce income,describe the use and portion
of the property utilized to produce income. C1/
44 ' 013-0g. due) - 0007 . 606--- do? .
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County Township County Township
I hereby certify the above statements are true,correct and complete. ignat re des' nt�L
Address(number and street,city,slate,and ZIP code) ti.
. IVt) S —O E aulo j- - flu 4/7 ,35
ASSESSOR USE ONLY TRUE TAX VALUE 'ASSESSED VALUE HOMESTEAD NON-RESIDENTIAL
I AT 100%OF TTV VALUE VALUE
Land not exceeding 1(one)acre immediately , a" "" .- t
surrounding residential improvements. (1) z-;-' e 4+? :rr
Other land (2)
Total land(line 1 plus line 2) (3)
Residential Improvements or Annually Dwelling (4) g '•K o"-,•
Assessed Mobile I Manufactured Home ""`,.-F ^1ivPi- } z`a:
Garage (5) tV4#4'•'atru. ,Sws;4%.. •'
Other Improvements (6) r = 4 :ti
k:
Total Improvements(line 4 through line 6) (7)
Total value (line 3 plus line 7) (6) .
•0I 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 as'nssed as real properly 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 Auditor Date signed(month,day,year)