HomeMy WebLinkAboutHomestead_Bayler in') CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
19 ':a_. ` STANDARD /SUPPLEMENTAL DEDUCTION
State Form 5173(R13/12-09) ORM
( i. 0 :
Prescribed by the Department of Local Government Finance r
INSTRUCTIONS:See reverse side for filing instructions.
Oi n/1 - _,CERTIFICATION STATEMENT • _ .- •
I(We) .t.�_�/ ��� �1� certifyithat I(yf9)ocgupi d as y(our)principal
place of residence or am(are)buying the following 1 cubed real property for which a Homestead PropertyGT 1 Ste N hereby claimed
under contract on the date this application is filed, (date of filing). I(We): SO COUNTY
AUDITOR
wn ❑ 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.
t - .- �.. _
- __ �--a:', �. : �'- . i�i!+.`� CL'AIMANTaS INFORMATION.. �. .�t�b.�_�.3`.�r - 3''-Fti.,.,:.•.',,.�
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If buying on contract,Fee Simple owner's name
Recorders office where contract is recorded Record number I Page r- _ --•. . - . 'P.ROBERTY DESCRIPTION,._ a _ --_?* • ''3:x
CounnV f Township Taxing•,a ct(cciitty town,township) -1
Parcel number Legal tim,, Iss trh—eyproperty in question: I
/�d /-7 G, I l./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 surroun s that structure is used to produce income,describe the use and portion
of the property utilized to produce income. -
cM-/a/7 da3 —ax0. / Z/-oozI
. ___ _. 1. ,�_ -
.., - �°a2yF PROPERTY OWNED BYCLAIMANT IN OTHERCOUNTIES --- -
1 County Township County I ' Township
hereby certify the above statements are true,correct and complete. Sgnnre'of claimant -
Address(number a • -a,dry,state,and ZIP code,'
ASSESSOR USE ONLY ITRUE TAX VALUE I-ASSESSED VALUE I HOMESTEAD-- I NON-RESIDENTIAL
s_ -. .c-: �ATs100%iOFTTV:.. -.VALUE- 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
Assesced Mobile/Manufactured Home Garage (5)
Other improvements (6)
Total improvements(line 4 through line 6) (7)
Total value (line 3 pia line 7) (8)
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)
• STAND ARD 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(12)of the assessed value of the mobile home or manufactured home.
Signature of Auditor Date signed(month,day,year)-