Homestead_Benson •°'" CLAIM FOR HOMESTEAD PROPERTY TAX I YEAR
STANDARD / SUPPLEMENTAL DEDUCTION FORM
State Fonn 5473(R13/12-09) HC10
\ ! Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for filing instructions. it 2- — /&& — p D
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CERTIFICATION STATEMENT •
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I(We) i certify that I( ccupied as my(our)principal
place of residence or am !e)buying the following described real property for which a Homestead Property Tax Stan D u on i 1e bed
under contract on the date 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 JUL 2 3 2013
❑ 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.
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Nell-', j- CLAIMANTaSINFORMATION. ,r, -. .,;.etbrilrPCs:.v, -t#•
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If buying on contract,Fee Simple owners name
Recorder's office where contract is recorded Record number . Page
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. .. _sPROPERTY DESCRIPTION - _ - ,. . - . . ,---
County Township Taxing district(city ttown township)
Parcel number Legal description Is the property in question:
0-60(- i'-ea,)‘, 7 ❑Real property ❑ Annually assessed mobile home(IC 6-1.1-7)
ony 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
the property utilized to produce income.
a4 -/8 -/3 - 9oq -000. 69 ) a - oa 4,
. • - - - PROPERTYOWNED BY.CLAIMANT IN OTHER COUNTIES a i • ,County Township County Township -'
I hereby certify the above statements are true,correct and complete. 1 -Si9na ire of claimant f `
Ai Address(number and street,city state,and ZIP code)
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ASSESSOR USE ONLY TRUE TAX VALUE AAT E00°/OF VALUE l HOVAELSUEAD, I NON-RESIDENTIAL -'�_
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 I Manufactured Home
Garage (5)
Other improvements (6)
Total improvements(line 4 through line 6) (7)
Total value (line 3 plus line 7) (8)
I hereby certify the above is true,cored, Signature of Assessor Date signed(month,day,year)
and complete.
Vaifying 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.
Signat 1 e of ,d41 )'-_ _ - Date signed(month,day,year)