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Homestead_Cox (9) CLAIM FOR HOMESTEAD PROPERTY TAX YEAR e n ! STANDARD / SUPPLEMENTAL DEDUCTION o i State Form 5473(R13/12-09) \,S l= Prescribed by the Department of Local Government Finance ' INSTRUCTIONS:See reverse side for filing instructions. JAN 2 1 2014 I(We) �`� • .r _ �._ >,. .. certify that I(w-i' rill,1i,' principal n .Y°7 ( ) place of residen•- or am(are)buying the following des '.ed real property for which a Homestead Property TaSfiligliNg:16101gplipryiAlupproptimed under contract on the date this application is filed, (date of filing). I(We): g 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 qualified personal residence trust ❑ Am (are)the shareholder, partner�orrsmember of the entity that owns the property. �� d• _, . .-a :,,:, If buying on contract,Fee Simple owners name 1 Recorders office where nbacl is recorded ' LA , Record number Pa qe a Ai. 5 - ,1-° e: 11 ' it -k .P,ROPERTY'DESCR pTIOIJA_' .g_.,ic ,....'- ra1r'. .-`.fix•i_- _- :°•t' County Township Taxing dist' (city,town,township) Parcel number Legal description Is the property in question: ale-l`k - Il-8 b b-Obit) 54 IS-b o co teal property El Annually assessed mobile home(/C 6-1.1-7) ti If any portion of the residential structure or the land not exceeding one(1)acre that immediately surro nds that structure is used to produce income,describe the use and portion of the property utilized to produce income. _ xZ ,,, ;,a rm•`.PROPERT•Y,OWNED-BY CLAIMANT IN OTHER:C�—ONTIEB'":77.4 `�fFic'�' 'r y_; Ffti'C d County Township County Township I hereby certify the above statements are true,correct and complete. Siggy�((�ure—of claim/ap/t n / Address(number and street,city,state,and ZIP code) 125"53 F')vOS 0 A)LLM11) C1aq iA) '-Z(_v(o& ASSESSED VALUE "HOMESTEAD s• NON-RESIDENTIAL - ASSESSOR USE ONLY : TRUE TAX VALUE - `S �-s r —s - - .., -ra.----ma:: _--.-a w 4th .ve m.r ra-,.ATo100/e.OFaTTV< L_.,iiVALUE ..-- .iv -.."4-rscVALUE'•=ate, ? Land not exceeding 1(one)acre immediately surrounding residential improvements. (1) Other land (2) Total land(line 1 plus line 2) (3) Residential improvements or Annually Dwelling (4) 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) (8) I hereby certify the above is true,correct, Signature of Assessor Date signed(month,day,year) and complete. Verifying action-Signature of Auditor Date signed(month,day,year) _. . ,. .. aSSTANARD`DEDUCTIONALLOWANCE - 2 7 _ 7- Y. 'j, y, _maa >: � --._ _ 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 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) a c l