HomeMy WebLinkAboutHomestead_Peek (2) a` CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
- STANDARD /SUPPLEMENTAL DEDUCTION FORM
� State Form 5473(R13/12-09) HC10
,•„ Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for filing instructions. I l-,
CERTIF:CATION• TATEMENT ' .. .. - _ _
I(We) I - - 'Tr certify that I(we)occupied as my(our)principal
place of re-dence or am(are)buying the follow' . described real property for which a Homestead Property Tax Standard Driduotial 4 7ffll)y claimed
under contract on the date this application is filed, (date of filing). I(We): J 111/��VV LCVU�I JJ
❑ Own ❑ Am(are)buying under recorded contract /)f
❑ 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 persofuiPe%QNSeQITY AUDITOR
❑ Am (are)the shareholder, partner or member of the entity that owns the property.
. ° "..
#;
If buying on contract,Fee Simple owner's name .
Recorder's office where contract is recorded Record number Page
. .
County Township Taxing di r'7 (city,town,township)
Parcel number Legal description / O� ^ .1, Is the property in question:
f/ r'v+ % ` ❑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.
AG, - la - o7 - ID ,, _ 000 . 50a _ oxg
- .--.. - . -:w. PROPERTYOWNED BY CLAIMANT INOTHERCOUNTIEs. .. ,� -. -County Township County .J _- M .Township y_-_
I hereby certify the above statements are true,correct and complete. Signatu claimant
A/Address(number and street,rip,state,and ZIP code) -�.� _
-C A t 2 nc- /O. a 417C-70
ASSESSOR USE ONLY .TRUE.TAX VALUE
ASSESSED VALUE HOMESTEAD NON-RESIDENTIAL -
. - . RU -. -.I_AT100yo.OF:TTV I.:...VALUE: VALUE - -2
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
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 property 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
2.c,/ Date signed(month,day,year)