Homestead_Babaian *VI CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
, OR
STANDARD 3
RD I M
SUPPLEMENTAL DEDUCTION FORM
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Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for filing instructions.
rjs �_ �. .v:t=+Y'=.li`1r5`
I(We) r_ /4a�����, Sea e--/•- _< ceNfy that I(we)occupied as my our pn opal
place of residence or am(are/t'ying the following described real property for which a Homestead Property Tax Standard Dwt /op,is11e by4daimed
under contract on the date i/-(application is filed, (date of filing). I(We): IY H 1 G 1 I
❑ Own ❑ Am(are)buying under recorded contract I JalYm
❑ 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 persogIcielfabilpiiiiifY AUDITOR
❑ Am (are)the shareholder, partner or member of the entity that owns the property.
.s �Ch°-a:'^Ewe-'-`"T-,i:Ja nw e: aril is OLAIMAN,T�S NiORMAT(ON � �'Y�d�' frf, c',:v u+`..ffa�'-vim. '.7�'MaSic'
F QA.��IJWC` �
If buying on contract,Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
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^".+�--T�t�v �� c�'a� ,hJSi�y�g��PROP,Ef2T,Y DESCRIPTION +-�-<,�r-•2eRS�m'k��v
County Township Taxing district a ,town,township)
A i 4
Parcel number L I ~✓Z. I � : ip question:
Real property C 7‘ 0 Real 0 Annually assessed mobile home(/C 61.1-7)
If any portion of the residential structure or the land not ex ng one( )we that immediately surrounds that structure is used to produce income,describe the use and portion
of the property utilized to produce Income.
160 - d3i(- /oo - 00% 462 - 0 ,tV
£ ..,... e h fr„=A 'E R_Ty.r�,ww r . a—..y-....,-_. Y.'�i ktns v' srf i. .tT'�5'-x :"a7i
:� ��_..��.-�;-.�� �,..x��'�'_P,ROPERT,s�OWNED16�CLAIMANT�IN�OTHER1000NTIESA�„t,�'��>+�,tx?:�_-,Tic.,rr->,�'-44
County Township County Township
I hereby certify the above statements are true,correct and complete. Sig to of tla nt
Address(number and street,city,state,and ZIP code)
V as . 5-k \ • r. ♦ 'Nye, 0.ub5#ac1-k- N H.-7 b 39
-/ y-a +, .,,-cswvi a a.pi---iz 1Sfx:T '.-$-.a7 t 7:;iir. t`T 7.?<(' SESSED VALUE I-` om—ESTEAD” ;�e NON RESIDENTIALT4}`.5s 4
i .- ,,,�ASSESSORUSE ONLY , TRUEETAX{VALUE Y' f1 - ,
'+ z ry,Riu E.9.NL ,.,ztes i/jai GE � AT 100%OFzT.TV?i VALUE T r -.: � .VAL'UE my
Land not exceeding l(one)acre Immediately F r i t:,--:-..,.--,-,. :
surrounding residential Improvements. (t) z �.
Other land - (2)
Total land(line 1 plus line 2) (3)
Residential improvements or Annually Dwelling (4) Y t x i.. r s; 'ci7:L .:
Assessed Mobile l Manufactured Home Garage (5) {-` ,t{ tir` '- ?-;^ ;
.
Other Improvements (6) ,k y..5
Total improvements(litre 4 through line 6) CO
Total value (line 3 Ow line 7) (8)
I hereby certify the above is true,correct,
Signature of Assessor Date signed(month,day,year)
and complete.
Velfying action-Signature of Auditor Date signed(month,day,year)
Yin`:iteg_`r =rY.deai .liAti, `i'STANDAROi arr.IO OWANC E frig,,,n+,x. r.:r i 4.k,4f.5'•.� .' ,iM ,titiA,
20 pay 20 Lesser of 60%of the assessed value of the homestead or$45,000
Notwithstanding any other prevision,the sum of the deductions provided in IC 6-1.1-12 to a mobile home that is $
not assessed as real property or toe 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,
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