HomeMy WebLinkAboutHomestead_Hornby n'' CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
et_ 3 STANDARD /SUPPLEMENTAL DEDUCTION FORM
State Form 5773(R13/12-09) HC10
,� Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for filing instructions.
�n fir Ii.,I(We) 4, i iww /I�fI�l certify that I(we)occupied as my our principal
place of residence or am(art ying the following described rea(roperty for which a Homestead Property Tax S nn arjD uctiop_t;i h H. :.aimed
and r contract on the date thi application is filed, (date of filing). I(We): I J -i
Own El Am(are)buying under recorded contract
❑ Am (are) entitled to occupy as a tenant-stockholder of a cooperative housing corporation SEP 3 0 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. - ..4.., e1
eC;: _ _ _ per; -- ,T,( _. •3 CI P.IMANT.S;INF_ORMATION`` : w. . < '� z 't`I ?i
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-. .--,e - 7:7, :._ .... _�:>�-,:.3:-";I � �< —� *2 . 4 ;- ----' .-
If buying on contract,Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
., r P,ROPERTXDESCRIPTIO N -4 _ Cis.;;,,,_ r _
County 7 Township T di 4.12-0a6'ci(city,town,township)
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Parcel number L-AP scri•lion Is the property in question:
r ` /
I�d Real property ❑ Annually accrcced mobile home(/C 61.1-7)
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 properly utilized to produce income.
J4 —/d-1U—/O/— OOO • Off` 06
._ .. _ ., ,,,:- _ - y,PROP,ERTY+OWNEDBY_CLAIMANT�INjOTHER COUNTIES �,-=�_•_ .. ;�,g°y - _ , � ,. _
County Township County Township
I hereby certify the above statements are true,correct and complete. Signature of a' ant {/!/,j—�
ddress(number and street,city,state,and ZIP code)
�,�'; (%L �"
• /_ S. � A • 4.alt e� . 5'76 X 0
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ASSESSED VALUE HOMESTEAD NON'-RESIDENTIAL '
ASSESSOR USE ONLY -�I>T TN(VALU tATe100%,OF.TTVtcL .-.=-VALUE-_ - "VALUE _ -..!V:-.....'
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)
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(12)of the assessed value of the mobile home or manufactured home.
Signature of Auditor Date signed(month,day,year)