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HomeMy WebLinkAboutHomestead_Haywood tom..- CLAIM FOR HOMESTEAD PROPERTY I P D • FORM YEAR STANDARD/SUPPLEMENTAL DEDUCTI JYYL-�� f:• State Form5473(R12/6-09) HC10 . Prescribed by the Department of Local Government Finance `- • DEC 21 2012 13 11 INSTRUCTIONS:See reverse side for filing instructions. c. . emu • _ CERTIFICATION STATEMENT (W ) L xr`,�- f i� r� t,.._r�y�i U NTY AUDI certi that I we occupied as my our e h' ( ) P y( )principal place of reside-ce or am(are)buying th!?/owing d•scribed real pro.' for which a Homestead Property Tax Standard Deduction is hereby claimed under contract on the data this application is filed, (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 Oust or the right to occupy the property under the terms of a qualified personal residence lust CLAIMANT'S INFORMATION Name of��ant(legal name) ' I / e• Name curity� - CONTRACT RECORDED If buying on contrail,Fee Simple owner's name Recorders office where contract is recorded Record number Page • . PROPERTY DESCRIPTION County Township Taxing distil city town,township) .1 Parcel number Legal description / ,, / Is the property in question: l.//,,1/on, `J'� //_A Real property ❑ Annually accessed mobile home(IC 6-L1-7) 410 If any portion of the residential structure or the land not exceeding ne'(17®°e"that~`immediately surrounds that structure is used to produce income,describe the use and portion of the property ua coed to produce income. a1,-1 a-019- 2_63 -004i 0/ -6 g' A I ) mint e • PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES County Township County Township Signature Idalmant I hereby certify the above statements are true,correct and complete. �tl/v �'!/yp/� c-� Address(number and street,city,slate,and ZIP code) !/t J I /\t,,' \) flood \1Ote 0,2,m (,Q,I(0 Pmces&n I 14-700 ASSESSOR USE ONLY I TRUE TAX VALUE i ASSESSED VALUE I HOMESTEAD NON-RESIDENTIAL AT 100%OF TTV VALUE VALUE Land not exceeding 1(one)acre immediately 1 y-ti�r,.Fe. „+v�t+'1a w9- surrounding residential improvements. O =grant,� s S 44d.•S Other land (2) >_>E `t 1k4 ' Total land(line 1 plus line 1) (3) Residential Improvements or Annually Dwelling (4) _'�,.w"2y' `. eB "' :4r-y°�s Acs sed Mobile I Manufactured Home Garage (5) ri+. * 1 Velcir''�r 5 Other Improvements (6) x; aFctii 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 Data signed(month,day,year) and complete. Verifying action-Signature of Audco Date signed(month,day,year) soSTANDARD DEDUCTION ALLOWANCE 20_pay 20 Lesser of 60%of the accncsed 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 property or to a manufactured home that is not assessed as real property may not exceed one-half(12)of the assessed value of the mobile home or manufactured hone. Signature of Auditor Date signed(month,day,year)