Homestead_Hogmire CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
',Wail; FORM
STANDARD/SUPPLEMENTAL DEDUCTION NCto
z-4�..•:.2 State Form 5473(R13/12-09)
' 7 Pneecnbed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side Toy fiing instructions.
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s`,-���arir-`r��c��.�°`-,rt_��,e,;a� - CERTIF,ICATIONjSTATEMENT�'•�� 4nY . �.-,•�.aR�'" .Fc r.`1 t:.
I(We) , D"Z ltn d-J a - certify that I(Y ]f ol as rt (g 1r)�$(,.-I
place of idence or am(are)buying the followi • described real property for which a Homestead Property Tax Stan ra D u o is er,b 1 ed
under contract on the date this application is filed, (date of filing). I(We):
❑ Own ❑ Am(are)buying under recorded contract APR 1 2014
❑ Am (are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation J
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified personal resid a tfust
❑ Am(are)the shareholder, partner or member of the entity that owns the property.
.,a(r i x- 1"".-c at r.: CTAIMANT'S11NF,0�_R ATlurv' h`x` 7 teggi.:'k,`'!'".,'LStr:, k
^€' .-:,-CONTRACT RCORDED, ,: sia aesK`n .ay* 4xa.n x1*?.
t
If buying on contract.Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
,r'S.-_- o.k in _,- '>:' `PROP,ERTIY,DE3CRIPTION liti;:'��,a r ' _.s 3-�,.J-:E.�.. Zu i:,r.
County Township Taxing .- (dN,town,township)
Parcel number Legal desorption Is the property in question:
❑Real property 0 Annually assessed mobile home(IC 6-1.1-7)
If any portion of the residential structure or the land not exceeding one(1)we that immediately surrounds that structure pome,desrn the use an man
of the property utilized a produce Income. l/`�/'lyj/,(tat
?-c .11 - 01 - (jQY - 70 (G ieo _ o ? 8 y
- a'rrS' •-=:• a"i $ . PROPERT 7,IFNNEO 1314CL onAs_NTM NinfijCOUNTiES 'ny-m .sit#' ,2 "e �'04.1i e eS.:g 1.'u:
County Township County Township
I hereby certify the above statements are true,correct and complete. ignawre of claimant
Address(number and street,city,state,and ZIP code)
X5,b dal• 1 _A • �c1� 2 a
r ial7,r� .,,,,, 3iR'b eta,,t'3 i lr ;, ",-4,,a ,-ii '�'ASSESSED VALUE'�c' ^'HOMESTEAD ¢ ` NON RESIDENTIALf. �i3'f•t
y`,"(, yi ASSESSSOR USE.ON, LY edit,Iai' I yRU AX,.VALUE;(I1ATL00%OFJT:TVS�iSt"Ia VALUEr' ' {`eel s"- `+VALUE Sst i1n:•
Land not exceeding 1(one)acre immediately 0- t- i•
surrounding residential improvements. (1) "4 s•; .-
-
L`-
Other land (2) r-
Total land(line 1 plus line 2) (3)
Dwelling (4) s7; '� i'T - i .c t.
Residential Improvements or Annually
Assessed Mobile I Manufactured Home Garage (5) ' s --
:,fl
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)
..ti'F S �a li .TZ - .3t, a'{lie SyANDARD DEDUCTION ALLOWANCE.;;W:Sr i'��-3. <L.3,Qt .e? _AM: i.-
�"• � ate• � � �Z._ .
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-hall(12)of the assessed value of the mobile home or manufactured home.
Signs of Auditn .- ,, , ,'€,_ Date signed(month,day,yew)
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