HomeMy WebLinkAboutHomestead_Bierman(12) ZeCLAIM FOR HOMESTEAD PROPERTY TAX YEAR
STANDARD / SUPPLEMENTAL DEDUCTION ';`M
State Form 5473(R13/12-09) H?10 - j,j
,� Prescribed by the Department of Local Government Finance . ' :-
INSTRUCTIONS:See reverse side for filing instructions. a
•- « j.^.ERTIFICATION STATEMENT I(We) adO._ _ ./.. 11(/_ _/_t_4I certify that e)ac sooeurr))principal
place of residence or am(are)b • the/flowing described real .erty for which a Homestead Property) ax sL COUNTY AUDI I UR claimed
under contract on the date this a.• 'cation is filed, (date of filing). I(We): GG
ACOwn ❑ 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
❑ Am (are)the shareholder, partner or member of the entity that owns the property.•ET?,.:4:4177 _ 'zz _4. : q2 _ CLAIMANT'S NFORMATI_ON a r .,. g., st : iY _ °
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.: _ ..
If buying on contract,Fee Simple owners name
Recorders office where contract is recorded Record number I Page
.I•
_; pROPERTI`DESCRIPTION - __ _.
County n/� 'X , Township Taxing ist.ct(city,town,t `g))`�'./'7
Parcel number U�' Legal description Is the pp operty in question.
Of‘-/9- do -/iv.DQQ / Q- ,r h((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 surro uds that structure is used to produce income,describe the use and portion
of the property utilized to produce income.
_ •
_ , , T - --PROPERTY�OWNED BYCLAIMANT IN OTHER COUNTIES,_ - I. 7 _,_ - _-
County I Township County I Township -.
Signature of,daimant - `
I hereby certify the above statements are true,correct and complete. ?C 5 rt nt r n j��.2 7/
Address(number and street,city,state,and ZIP code) /� x... '/.")'/UX{y�/.y
'/,Ts Frig' / /, ^_� 41 ,
d A _ H_ A ANON- NTIAL q
ASSESSOR USE ONLY I, RUE TAX VALUE D -
Land not exceeding 1 (one)acre immediately
surrounding residential improvements. (1)
Other land (2)
Total land(line 1 plus line 2) (3)
Residential improvements or Annually Dwelling (4)
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)
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 properly may not exceed
one-half(1t2)of the assessed value of the mobile home or manufactured home.
Signature of Auditor Date signed(month,day,year)