Homestead_Skidmore <`°'"o CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
s!_. A STANDARD / SUPPLEMENTAL DEDUCTION FORM State Forth 5473(R13/12-09)
�' ,.„ Prescribed by the Department of Local Government Finance _ --
INSTRUCTIONS:See reverse side for filing instructions.
.CERTIFICATION STATEMENT _ - .-
I(We) le• Iv i V I,_�.�.%�� iv .1 ui • certify th. (w: -.... . . ..principal
place of residence or am(are)buying the following des: bed real property for which a Homestead Property Tax Standard Deduction is hereby claimed
under contract on the date this application is filed, (date of filing). I(We): OCT 1 1 2013
❑ Own El Am(are)buying under recorded contract
❑ Am (are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation
❑ Have&beneficial interest in the trust or the right to occupy the property under the terms of a qualified pyl AO� AUDITOR
❑ Am (are)the shareholder, partner or member of the entity that owns the property.
_ .j -.-k - =,ti ,y ,;We AIMANT�SI�OMAT(ONWi, t...z,' g F� �_ 1' ',2:- ...-'
._.
If buying on contract,Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
rt. e.- - f.'- ;- .".- e. - . 4' - . 'PROPERTY.DESCRIPTION - ' - r °
County Township Taxing district(city,town,township)
613 ar I umb /`/� /� L?q)al description Is the property in question: .
t-/CO—b00 'd — Ob� ❑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.
.• _ . '-.-�is.#,S.. PROPERTY.OWNED BYCLAIMANTIN OTHER-COUNTIES ,�j:" .. +tic-i-sz,, • , -:
County Township County 1 Township
I hereby certify the above statements are true,correct and complete. re of olaimant
•
Add:-ss number and street,city,state,and ZIP code /
• 11 ASSESSED VALUE "HOMESTEADY NON-RESIDENTIAL
ASSESSOR USE ONLY - -TRUE TAX VALUE
AT5100%tOF<TfY. „ - -VALUE
Land not exceeding 1 (one)acre immediately
surrounding residential improvements. (1)
Other land (2)
Total land(line I 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 plrs 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)
L