Homestead_McRoberts (3) CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
;%._-a,;. FORM
s STANDARD/SUPPLEMENTAL DEDUCTION
,.k5 '� State Form 5473(R13/12-09) HC70
Prescribed by the Department of Local Government Finance ,
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+' . +.-x..:: ",�+: "CERTIF.ICATIOA STATEMENT' �, --'; i. S f"�v.I'� S. r£9-.Mr
I(We) 10iSlarne Li, _A._4,, certify that I(we)occupied as my(our pnna
place of 7-sidence or am(are)buying the following de •bed real property for which a Homestead Property Tax Standard Deductipg it hCrgby i�a ed
under contract on the date this application is filed, (date of filing). I(We): M)-11t U 1 1014
❑ Own ❑ Am(are)buying under recorded contract `///�[
❑ Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation .J lPlP1tL —
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified personal raiM atinaOUNTY AUDITO•
❑ Am(are)the shareholder, partner or member of the entity that owns the property.
S aTi_'P `t d' �`�"-'^+3 5[1;y; 'It rlE AIMANPS INFO1-70:1761710102,/fir" J3 05111: 1/WE4titili
If buying on contract,Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
la:Laira hairs ..'cu rnif.3-z'r grillaki4 P•RO_PERT:Y DESCRIPTIO'�N7 rSitta3;.'!: ice. . -Saaf 1/4.t`i4 ciiiic".;` .
County Township Taxing•Ii.(cny,fown township)
Parcel number Legal d�rfiplion �� / Is the�o-,aty in question.
"7Cln
Legal
Lqe ❑Real property ❑ Annually assessed mobile home(IC 8-1.1-7)
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.
to-05 - 33 - 3 00 - ooti. yi3 - 0 r_ 7 -
MifrSS :f- g'Rjirdfz " tPROPRfI7zrthi Air- IMAN7NiN,OTHER CODNTIES aaiatXRZ '•'a'•+ Krems--:r-f. -`_1:G'
County Township County Township
I hereby certify the above statements are true,correct and complete. `j,��`/ � �,,
Address(number nd.• city,st a L ode. V�V4/ 96 7d
s�Gy�i r1 1 s-ai 'r.'" sit-- : c` =."5" '>-trw-`'afri- `�aASSESSEO VALUE' g?HOMESTEADp"p' ''-^NON RESIDENTIALI` ;;y41
914-- v ASSESSOR USE�ONLsY�' xi ' -�1�yRl1EeTAX!VALU ,..ATIe oogoiowatVa7 it-4 `sVALUEs nisi a�C s s tVALUE . 'ic s ,
Land not exceeding 1(one)acre Immediately (1) '.5:-' r ,�" 1 :!;,:.1..c
surrounding residential improvements. Ti
Other land (2) .4.." 34^2,-12,-.
Total land(line 1 plus line 2) (3)
Dwelling (4) _ :i s.. 'r. +. _?, ct.-:
Residential Improvements or Annually -
Assessed Mobile I Manufactured Home Garage (5) _ ` rs. s -- .•..
0,?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.
tVeriying action-Signature of Auditor is Date signed(month,day,year)
VkYf: '- ,xd r-fii431r rib' i..M11::fa:gTANDARDaDEDUCTION(ALL0—Iki—Enaf:4.4:1—'°. .• -a-Mavi,tf�-R11.4 4: 0
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 popery 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)