HomeMy WebLinkAboutHomestead_Walther (6) CLAIM FOR HOMESTEAD PROPERTY TAX i,=�
.b_ STANDARD 1 SUPPLEMENTAL DEDUCTION � ��{
State Form 5473(R13/12-09) I® /�../
�' ,01� 1 Prescribed by the Department of Local Government Finance I-v
INSTRUCTIONS:See reverse side for filing instructions. NOV 15.2013
oa CERTIFICATION STATEMENT
I(We) I/t('1jLr�' - 9t- •0S,09 certify that I(we ��. i.'71- 1�•�.�ur,�r)7�Tpri(�npcipal
place of residence or am(are)buying the following described real property for which a Homestead Property TaxG1$2Ol rsaargT!IRiCBJ GQ ied
under contract on the date this application is filed, (date of filing). I(We):
N Own ❑ Am (are)buying under recorded contract
(ff recorded
(are)entitled to occupy as a 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.
' ..
If buying on contract,Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
.1
PROPERTYDESCRIPTION - °a - '
County Township Taxing district(city,town,township)
Parcel number Legal description - Is the p party in question: I
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 surr nds that structure is used to produce income,describe the use and portion
of the/property utilized to produce income.
01‘"77/a/".40 —000. o& —00202-
• - , - - - iPROPERTYY OWNED•BY CLAIMANT IN,•OTH-ER"COUNTIES - .. _.
County Y Township County Township u
I hereby certify the above statements are true,correct and complete. Signature of elaimam
Address(number and street,city,state,and ZIP code) X 1� - K- !,J -,�_
it,, O /f'I-• SW - ✓ - h 14S
ASSESSOR USE ONLY. _ I TRUE TAX VALUE SSESSED.
OF TTVE( HOVALUEAD I NON-RESIDENTIAL-
Land not exceeding 1(one)acre Immediately
surrounding residential improvements. (1)
Other land (2)
Total land(line 1 plus line 2) (3) I
—
Residential Improvements or Annually Dwelling (4)
Assessed Mobile I Manufactured Home Garage (5)
Other improvements (6)
• Total Improvements(line 4 through line 6) (7) I
Total value (line 3 plus line 7) (8) • I
I hereby certify the above is true,correct, Signature of Assessor Date signed(month,day,year)
1 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 mat property or to a manufactured home that is not assessed as mat 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) •