HomeMy WebLinkAboutHomestead_Cooper (2) °'D ' CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
; STANDARD /SUPPLEMENTAL DEDUCTION FORM
• If State Form 5473(R13/12-09) O C THgW 2013
Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for filing instructions.
-.--_ ����' � • CERTIFIICATION,STATEMENT - '�� -
I(We) Ti ,�fL graIf)) -w�! certify that I(we)occupied as my(our)principal
place of residence or am(are)buying the following described r=:l 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):J4 / r�
;t Own ❑ 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.
-: CLrA1MANT.' IS IS NFORMATIOIJ� �°_? % .-,rs;. - - LL+: .z._-
_- _
If buying on contract,Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
• LT.* - , _`' — - _ <
County Township Taxing district(. ,/r township)
-L41,0 /V
Parcel number - Legptliescription Is the property in question: I
4 4/ /7- g_�v Real property El Annually assessed mobile home(IC 6-1.1-7)
If any portion of the residential structure or the land�exceeding one(1)acre that immediately surrounds that structure is used to produce income,desoibe the use and portion
of the property utilized to produce income.
34_ /a -/ --/o3 . co a. G0 3 - o a g-
_ _
.• . +b�>PROFERTY OWNEDBY CLAIMANTIN OTHERi COUNTIES :
County I Township County Township
I hereby certify the above statements are true,correct and complete. Sgnat of�cl+aimant
Address(number and street,city,state,and ZIP code) / i 1��
rL L / d1 N „Sr
-ASSESSOR USE ONLY _I TRUE TAX VALUE I ASSESSED
T.100°/o OF-TTV HOMESTEAD
-VALU -I NON- VALUENTIAL
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(lined through line 6) (7)
Total value (line 3 plus line 7) (8)
I hereby certify the above is true,correct, Signature of Assessor Date signed(month,day,year)
and complete.
Verifying action-Signature of Auditor Date signed(month,day,year)
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•-' 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 Date signed(month,day,year)
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