Homestead_Block (2) CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
I
'tilt__ - l STANDARD/SUPPLEMENTAL DEDUCTION FORM
State Form 5473(R13/12-09) HC10
\l:<-- Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for filing instructions.
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•I(We) .1—��'Lare!_ `._ 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 StanDKO!ctZp3 hereby claimed
under contract on the date this application is filed, (date of fling). I(We):
❑ Own ❑ Am (are)buying under recorded contract /�/
❑ Am (are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation y JbI fft1 �f
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified perrsonnal resilience trust- UDITOR
El Am (are)the shareholder, partner or member of the entity that owns the property.
- . . _. _1 . -CAIMASINFORMATON„ ��-- _ •-
Y -Y' _, -/`z
. ,
If buying on contract,Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
__ .. ...-..:Y. . . _ n �- :".P_ROP,ERTY:DESCRIPTION4,;- _ .. . .t.. 4-1C-4.._.. -. a:
.County Township Taxing 'strict(city to ,township) I
Parcel number L al description /A L Is the properly in question:
E - s C . 3 60...a1 ..:10 ❑Real property ❑ Annually assessed mobile home(IC 6-1.1-7)
It any portion of the residential structure or the land not exceeding one(1)acre that immediately surrounds that structure is used tb produce income,describe the use and portion
of the property utilized to produce income.
ado - / 2 - 3Go- 9-OO - oo /, -2 23"- ooh!
., -q*- PROPERTY OWNED,BY CLAIMANT IN OTHERCOUNTIES i, _g�, -, ->f,,,;L. ,_
County I Township County I I Township
Signature cl imam //L%� /�(P�, ..
I hereby certify the above statements are true,correct and complete. X
Address(number and saeet,city,state,and ZIP Dade)' �� . I -
6 nQe .0h n • U
ASSESSOR USE ONLYL`�_I TRUE TAX VALUE-: ASSESSED_VALUE I HOMESTEAD -I� NON RESIDENTIAL""
-. a.aavi :-t. .,ATn100% :eVALUE.:v VALUE. . _. . .
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 plus line 7) (5)
hereby certify the above is true,correct, Signature of Assessor Date signed(month,day,year)
I and complete.
Veitying 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 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.
/ Signatur of[i I Date signed(month,day,year)
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