Homestead_Stone o'°•",. CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
€* STANDARD/SUPPLEMENTAL DEDUCTION CRo
L1 State Form 5473(R13/12-09)
S ,a�• / Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for filing instructions. .
i _ ice,
CERTIFICATION STATEMENT - -
I(We) a e-c._-____ i
L lt �1. certify that I(we)occupied as my(our)principal
place of residence or am(are)buying the following described real property for which a Homestead Property Tax S f-d u�jr is hereby claimed
under contract on the date this appli.= '•• ' -• (date of filing). I(We): c ��Lu f
9)
❑ Own a Am are buying under recorded contract 7��[t
❑ Am (are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation GIBSON rn'1AITVVV
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified persona?r25ldetlR
❑ Am (are)the shareholder, partner or member of the entity that owns the property.
s•...._
IF buying on� d,Pct ee Simple owner's name `6. - -
Recorder's office where contract is recorded
��%}� '/C'-(-- Record number Pa•e
r_.
I r3 .i
0PROPERTY:DESCRIPTION -`: - . . L , - . _ _ • ._
County Township - Tax;/( district(city, curt,township)
Parcel number Legal description /y, / `![/��I�Is the property in question:
/9.'![A0 tr/jcmn' oTLJ 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.
M -DY- ay- 3o y - °°0- 353 - o ?-o
_ .
- _ _ PROPERWOWNED BY CWMANT IN OTHER COUNTIES„- __- ; ti. -• a
County Township County Township .,
I
I hereby certify the above statements are true,correct and complete. \ Signature of a t `
/Address(number and street,city state,and ZIP code)
,�lU/
••• • ua■n J _ _
USE ONLY. TRUE TAX VALUE!l AAT E00° OF_-Tf VE I HOVAELSU EAD I NON-RESIDENTIAL
ASSESSOR
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/Manufactured Home Garage (5)
Other improvements (6)
Total improvements(line 4 through line 6) (7)
Total value (line 3 pits line 7) (S)
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)
- ST IDARD,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.
o
Signet e Art,Jett) Date signed(month,day,year)