Homestead_Wilson (8) CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
tst I E
STANDARD/ SUPPLEMENTAL DEDUCTION
it„.:. State Form 5473(R13/12-09) C�
Prescribed by the Department of Local Government Finance r \IF . . • It. ,
INSTRUCTIONS:See reverse side for fling inshuchons. , ,l , 1 MAY 1 2 2014
.",rssg� ,x l_as�:77��S� ar..�:. :ist C-l; s-"" T CERTIFICATION STA EMENTw-; :� 'i:.' t..'' ',ti a j � is T.
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‘��11��` !M�i-sm (our) rind
I(We) 'i`sa��Jl'�»«�!f�, cerbfy , �,; : c:• my( )D Pa
place of residence or am(are)buyi g the following described real property for which a Homestead PropsliestaffOrglard IiiTabciiiingDffigiby claimed
under contract on the date this application is filed, (date of fling). I(We):
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 or member of the entity that owns the property.
,*i= _c4 s .Wfii t k fall LAIMANT�Su'INFORMAT)ON {r`.k2 1�a'Yhi+.r�''``^C-.. rat .Z.V.O,'Y:,sc.*.3":b&^a' Zit
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-a'-.3-.a.�c�. .�z�"•r�.'w�. 3+�.r.'_•'+7�"t"�*� SFsu"�`}''.""' CONTRACTIRECORDED. ��.-ev�w""Y F?.t�nD:w+J,3��'�n..r�,.,.a....�rwr.t-_-t,3+ffv
If buying on contract,Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
=,�;,g�_ arc ���� � �y�.,,ro�P-R�O•PERT;Y DESCRIP-TION•^�`1 '�^"t.r' '-'� *�' }
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County Township 7a q o�e T Lc*
Parcel number Legal description ``J Is the property in question:
'a L� A. .‘QS- I as — . 9 5 D-c77 ❑Real property ❑ Annually assessed mobile home(IC 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.
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"�'T�,. ^ '� �'.PROPP,ERTIY�OWNE18V(CLAIMANTgIN,OTHER COt1NTIE5���`_r�`r 1„t�?_h �-._„i.V,,,; . :�...cs :-t
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County Township County Township
I hereby certify the above statements are true,correct and complete. "tut(caiman D .,_,-kr...,
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Tess(number a 4 city state 1 code)!
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r4.4 i r^"z'-{ ethav r.iav '.. '`#.>.a4- *-_foi14 ”ASSESSED[VALUE.)ttvHOMESTEAD12,ivez, o-KI RESIDEN7IAiwzi t-
+yI, �ASSESSeOR i�aON Y i�y� 1-:`TRUE)TAX+•,VALUE t ATG100%.OFiTeTVSFSkVALUEii `�xl E-a.'"L*p- '. 'btivAL'UE e ..St.+
Land not exceeding 1(one)acre immediately (1) 7 1,.�� .,>
surrounding residential Improvements. ..'1,,,-'
. -
Total land(line 1 plus line 2) (3)
Dwelling (4) '—' h ,,.-.:, fi f.- v.
Residential Improvements or Annually ,Assessed Mobile I Manufactured Home Garege (5) h"`3 " r � `'.�.Lr �'.a#:
Other Improvements (6)
Total improvements(line 4 through line 6) (7)
Total value (line 3 plus line 7) (6)
I hereby certify the above Is true,correct, Signature of Assessor Date signed(month,day,year)
and complete.
Veifying action-Signature of Auditor Date signed(month,day,year)
k ;xilif.'�4.r° .; ' CIZ "-dl+ �e"L` ^.Y+ -1711WIiRD� IEDUCTIONAL OWANCkil 4,Witt, : - �"v lsx;jt?' fI. f£-.4?
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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.
Signature of Aud rtnr Date signed(month,day,yea
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