Homestead_Coy CLAIM FOR HOMESTEAD PROPERTY TAX �j�*_y�
': STANDARD/ SUPPLEMENTAL DEDUCTION �;!
State Form 5473(R13/12-09) H
�' ,��' Prescribed by the Department of Local Government Finance
NOV 5 2013
INSTRUCTIONS:See reverse side for filing instructions.
1(We) certify Fel B l9 ristrnAistWirtiRipal
place of residence o m(are)buying the following described real prope r which a Homestead Property Tax Standard Deduction is hereby claimed
under contract on the date this application is filed, (date of filing). I(We):
U.I., n ❑ 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.
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3 .akilbr43tt .-•c. `.',, _CLQIMANTaS11NFORMATION 1--_si_'- __ _ . 1%--311i3V-;;:l
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If busing on contract,Fee Simple owners name i -
Recorders office where contract is recorded Record number Page
,1•
- _ ......PROPERTY,DESCRIPTION .- -. s
County Township I -ng ' trict(city,town,township)
Parcel number Q (J /�q� Legal description Is the property in question: I
ac,-13 - [ 4 -4 V. ) O° C)w vs Y 6 ,,if eat 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 surroun s that structure is used to produce income,describe the use and portion
of the property utilized to produce income.
-. - . ..
-. ;e PROPERT4'.OWNED BY CLAIMANT IN OTNER'COUNTIESr.. - -. :. - —.,,
County Township County I Township
Signature of claimant
I hereby certify the above statements are true,correct and complete.
Address(number and street.
city,state,and ZIP code) I
-1 a1 • I • W . I__ .. • 1 -7 I i •
ASSESSOR USE ONLY rTRUE TAX VALUE ASSESSED:VALUE I HOMESTEAD'- I NON-RESIDENTIAL
AT,100/.OFTN - : VALUE VALUE
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)
I hereby certify the above is true,correct, Signature of Assessor i Date signed(month,day,year)
and complete.
Verifying action-Signature of Auditor I Date signed(month,day,year)
STANDARD.DEDUCTION.ALLOWANCE - _ f -
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 ditor Date signed(month,day year)
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