Homestead_Naas (12) CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
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� STANDARD/ SUPPLEMENTAL DEDUCTION HC10
vi:i. . State Form 5473(R13/12-09)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for filing instructions. 8/ A , /, q- 011 31
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,��s�`'�-�1s1 ,y�P,�y�ilrfi `^'' 11 x' CERTIFICATION�STAT EMENTa�' .r„1e��•z':>EL�v�v t`�.:.t��r�z”=��•.;' G' -Y.�•_:L
I(We) i4/ ff '4- Alf.4. .�i_1 I /r/ certify tha�g0Jgl�((t*�e Wed (, r'ndpal
place of residence or am(are)buying the following described real property for which a Homestead Property Tax $tie D u 'o is el- '•aimed
under contract on the date this application is filed, (date of filing). I(We): g
❑ Own ❑ Am(are)buying under recorded contract MAY 12 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 - ence st
❑ Am(are)the shareholder, partner or member of the entity that owns the property.
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_ -'�- -.'; "A* � ''ti9rER-' 'CONTRACT'RECORDED. �.'� 'r� %ar'�e.+` s.tliais•.a..r'�''.a`'fi. �`�1°_.;...u�'•.'�F'
If buying on contract,Fee Simple owners name
Recorders office where contract is recorded Record number Page
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County Township Ta ' " (dry,town,town • )
Parcel number Legal description 3.4 -ii on Is the property In question:
�-f co E a.7 73 ❑Real pmlxny ❑ 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 S used to produce income,describe the use and portion
of the property utilized to produce Income.
AG,- 2 .1 - 03 - aoo - ooeA . 3 $ 7-0ar/
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-���,'-Y���`}"�.?;x '�3"����a�?'�x '.PROPERT,Y,dOWNED BV C a A�_hTjINOTHE ACOUNTIES: �.'-�'�L�,arj'}�''. t,�';-s ;�,yi't„r�:-.��
County Township County Township
I hereby
(ccertify the above statements are true,correct and complete. - /Sspa�e of claimant , r-, _ 1,
✓ /VU berandrt.rx �andZIP - ,Xl\.11 A 1/96 ^ (`-rIW/1\14\�
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,yr.. sr�• n.,.rosy rte» .s�e.w...ti„yaga -..'r>* fly y.l,rs i .°"'l�'r,7gSSESSED VALUE :acioMESTEAD Yc1i-StTNON.RESIDENTIAcesvj``.
,yd- ty ,7•ASSESSOR USE ONLYc tax t, roTRUEc....aV=AL- .- ii AT loo0 .OFJT,T,VUII„ a3.VALUE;u t rt :rx'e , VALUE c •rte c:--
Land not exceeding 1(one)acre Immediately (1) j- t ,a k
surrounding residential improvements. - --
Total land(line 1 plus line 2) (3)
Residential Improvements or Annually Dwelling (4) ?T+ .+,m.. '.t 's•= r
Assessed Mobile/Manufactured Home Garage (5) a °-;s.w,.,-mss i, -'ter
Other Improvements (6) - 4:,
Total improvements(line 4 through line 6) (7)
Total value (line 3 pits 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)
.41.- <' c.+-\•mot" -' -MUlk s.+tit'si^Jlt,Eg STANDAR6EDUC,TION AL OW4.1. tnsdr?4:11W'r^v.i.+:f CW-S1s'6.,.ki.F, MS.g`t C.
20 pay 20 Lesser of 60%of the assessed value of the homestead or$45,000
Notwithstanding any other provision,the sum tithe deductions provided in IC 6-1.1-12 toe mobile home that is $
not assessed as real properly 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.
SignaWr 01 nt ,/c//..2 Date signed(month,day,year)