Homestead_Donaldson t.'�Tr CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR I
STANDARD/ SUPPLEMENTAL DEDUCTION HC10
-C .. State Form 5473(R131 12-09)
0--' Presabed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for filing instructions.
r :s.°. 'rail:ve a m•__-M r. tifiaa.� �. 3, ; - >» lili
y„` ��4�rr�="�''� azffyt ��-why "f_ CERTIFICATION,STATEMENT�y,� - � ���„A.3.z>u eY"r� �_, '�?.,u° �Z'�'-fi
I(We) . Ai ! - .•4at `)S! .. AS certify that) 12 a as .II•ua :pal
place of residence or am(are)buying the following described real property for which a Homestead Property Tax Sta 'la • r;.. io iT he -•!V' ed
under contract on the date this application is filed, (date of filing). I(We):
❑ Own ❑ Am(are)buying under recorded contract MAY 0 7 2014
❑ 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 resid ce trust
❑ Am (are)the shareholder, partner or member of the entity that owns the property. jQMC`
. Wiz.,., a4-.;cif > ..� .+��.�gri i FT-6. t •a...-_ rc, .,..- u .-, v: ��s..-rzg 'L:`tf,°;•fe-SC
�'-'����"I.P ^°'*'�- '1 ��k+Pa�tta��`'�+3�,F�•�:4�:tr3l�`•eN .CL�AIMANTiStINFORMAT,IOIJ�'�.°537e'�G�,Ct�s ��ri ��e"e'.�„e...-I.3Y�'-t>`�%�+t1�
'..
If buying on contract,Fee Simple owner's name
Recorder's office where conbad is recorded Record number ,.,p,Page
>< �k 4_�?.�¢��.� °-,a�-y;�;V�tvZk� ,ePROP,ERTjYjD ESC-RIPTIONIt"3p�>�c�'et5,,,..�f�`a�;.r
ariiian
County Township Taxing district(city,town,township)
pawl number Legal description Is the property in question:
O —QU' „/1/q-3 D4-vco, 4 6-D D ❑Real property ❑ Annually assessed mobile canna(IC 6-1.1-7)If any portion of the residential structure or the land not exceeding one(1)ace that immediately surrounds that structure is used to produce income,describe the use and portion
of the property utilized to produce income.
;41.1Wa�-�:3at.�rY& 'aeFROPERTrYiONINED BY,CLA(MANTy1N OTHER,�COUNTIESr7.&SyStis°:c„!t,<-, _tL- ,f<.Eti 4&•ck `a.^„-.rt
County Township County Township 1
I hereby certify the above statements are true,correct and complete. Signature o anent
Address(num• r and street, ax
city state,and ZIP code)
/v i.[iYll)f!GL 4-u0 fe ae�•->
i i. L te . l s' / S r - 'r e d r cl7(e1¢
7-3 f-li+`. 1*>t-1�- l-tred- _ -- ^ -`R,rb`'r=tPF rI-'{R w+- vt-VALUE TASSESSCD VALUE'.sARTO 5TEADtkp. ??NON RESIDENTIALry ,
.0 ccd.AS5Ei, RUSEONLY��xa w�: �),TINEjTAX;VIVAALUE7(VATSTOOW 0EifiT,V.it itt2?.VAL'•UEWC:'ie,SEi .. VAL'UE ( - a.'i '
Land not exceeding 1(one)acre immediately CO . ,
surrounding residential improvements. ..
Other land (2) p-y'''''.4.!;;• S 't-4-.T,_-
Total land(line 1 plus line 2) (3)
i s
Residential Improvements or Annually Dwelling (4) '` •.-'c .r fl -' -___
Assessed Motifle I Manufactured Horne n- a
Garage (5) r •'Y .F .P
Other Improvements (6) --
Total improvements(line I through line 6) (7)
Total value (line 3 plus line 7) (a)
I hereby certify the above Is true,correct, Signature of Assessor Data signed(month,day.year)
and complete.
Verifying action-Signature of Auditor Date signed(month,day,year)
^.'2'.=�r} -t. h^ �r: r i '.+ ,` i'riedi ir§TANOP. OWDUCTIONAL'LOWANCE'' YT'c '-`” x„'r l°`' " 'fir_`E�;r`�t
�t 3..,3"`^..1u,�<«+ ' �`bTa'?'S•�'_-'3tn.�i' i•. :t'3,.SU'tnl'�..�m.._.. .�__ ,... .,_-_.�.__•__..m'usa.�...,.-s",`�. .a.,r..,..:. .,� a'�.,f'. ..r��,.
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(1/2)of the assessed value of the mobile home or manufactured home.
Date signed(month,day,year)
Signature of Auditor