Homestead_Fultz CLAIM FOR HOMESTEAD PRO PET A,Xrr YEAR
STANDARD/SUPPLEMENTALDEDUGTION FORM
i' State Form 5473(R13/12-09)
, B Prescribed by the Department of Local Government Finance
F3202014 /'
INSTRUCTIONS:See reverse side for filing instructions.
which a Homestead Pro Deduction is hereby claimed
under contract on the date this application is filed, (date of filing)GI M N COUNTY AUDITOR
P2/Lwn ❑ Am (are)buying under recorded contract
MI 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.
i- .. , i!-�. y. � y� ..y s, eys.
'. >:.ii:; .+--•a. -. ' � , -CLAIMANTaS.INFORMATION_- ��, . ..�,-„_.t �s„s rift .. ..�;-y+- S�h.¢--v_ -.
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If buying on contract,Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
• ..�1 P,ROPERTY,DESCRIPTION - - ryvn - - :
County Township Taxi dr ilg sbila(city,town,t • ship)
Parcel number pfion ��/-^I`s//thhe property iin question:
(-JCrC/ i',jam / 1y�1'Real property ❑ Annually assessed mobile home(/C 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. /
c740-/7-0 / - lice oc / 9 0 0 O
- - - . PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES - • - - --
County Township County Township ..
i
I hereby certify the above statements are true,correct and complete. Signature f claimant `
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Xdq tlrqss number -GA st-t and;l:..e) - � , `r KS t1� tob_
ASSESSOR USE ONLY, ' TRUE TAX VALUE AT ESSED VVALU .I. HOMESTEAD I NON- ESIDENTIAL
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/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)
' ' . 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(12)of the assessed value of the mobile home or manufactured home. -
S' �+�f Auditor c Date signed(month,day,year)
C� (LPJVti.� 07 -070 -/41