Homestead_Baker (4) i
..• CLAIM FOR HOMESTEAD PROPERTY TAX
.4... 1 STANDARD /SUPPLEMENTAL DEDUCTION FORM YEAR
State Form 5473(R13/12-09) HC10
.� ,°1° Prescribed by the Department of Local Government Finance /� / -
INSTRUCTIONS:See reverse side for filing instructions. $t L { t+ _ r'0 tf o q
CERTIFICATION STATEMENT
I(We) - �. .a L. / i_ J certify a I( .: •.i-: _ )Principal
place of residence or am Cr-' .uying the following described real property for which a Homestead Property Talc Sts rd Deduction is hereby claimed
under contract on the date this application is filed, (date of filing). I(We): `OE C 2.3 2013
❑ 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 qualiferiBSeN 0019. DITOR
❑ Am (are)the shareholder, partner or member of the entity that owns the property.
1
w_... -� .. ., ., - .v
,. - �.-ia� �"�.. � F_- - CL-AIMANTxS;INFORMATION:,_—„ _ _ _ �;°? . _ ��__ y45.�' ? .
: " ;-,... . . -,
If buying on contract,Fee Simple owner's name - I - -
Recorder's office where contract is recorded Record number Page
.I
.. - - - - . .-PROPERTY.DESCRIPTION , _
County Township Ta '' district (n
Parcel number L al description t, ' Is the property in questiort l
'
�/„Z, / 2- ['keel property ❑ Annually assessed mobile home(IC 6-1.1-7)
If any portion of the residential structure or the land not exceed' one(1) a that immediately surrounds that structure is used to produce income,describe the use and portion
of the property utilized to produce income.
a& . 23 -/ 4 - ,too - ooc2 . yea_ oay
• . _ -- PROPERTMAWNED BY.CLAIMANTIN OTHER COUNTIES �- . . .y .:
County Township Countyyr� r I - Township a
I hereby certify the above statements are true,correct and complete. ignat of claimant i A I
Addre (number and street, A.,state.an•ZIP code) ( �T a p7,(Q'_II �l,/���
X Z7 •- I : 1 ► III-L...-J•-
ASSESSOR USE ONLY- • -'_I TRUE TAX VALUE 9 AT.700%OF LfV _I HUVALUE , 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)
Dwelling (4) `
Residential improvements or Annually
Assessed Mobile I Manufactured Home Garage (5)
Other Improvements (6)
Total improvements(line 4 through line 6) (7)
Total value (line 3 pits line 7) (8)
I hereby certify the above is true,correct, Signature of Assessor Date signed(month,day,}rear)
and complete.
Verifying action-Signature of Auditor Date signed(month,day,year)
Y ' ^ STANDA litEDUCTION A-LLOWANCE-
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.
Signs ure of Auditor x Date signed(month,day,year)
�(r_wr�ly V