Homestead_Miller (4) f�.:i CLAIM FOR HOMESTEAD PROPERTY TAX FORM
YEAR
' , STANDARD/SUPPLEMENTAL DEDUCTION OR
Tec::„-. State Form 5473(R13/12-09)
.'gy Prescnbed by the Department of Local Government Finance (/ <
a- 'a
I(We) 11 �Y�)/ fit r certify th Wed s y ! tr rindpal
place of residence oram(areybuying the following deserted real property for which a Homestead Property Tax d l du ti' 1 i h -r, claimed
under contract on the date this application is filed, (date of filing). I(We):
Own ❑ Am(are)buying under recorded contract JUN 24 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 res' enpe st
❑ Am(are)the shareholder, partner or member of the entity that owns the property.
�...rt a "i1 rNaF 1$:t3 '�r+1X" -s v..-.;P eve.ffri a.e l i1e f x. _.e '44 5 -si^=.:
'� ..�,v r c -. - ..,, CLAINIANT4SJfJF,ORMAjION3+�...d4.- �C'�._. �-.=,-
�e• s`t.` =`%.d t.q altal. '
If buying on contract,Fee Simple owners name
Recorders office where contract is recorded Record number Page
- Xy�� i r f-T lar ' 'Wa'� PFN T;Y'DESCRIPTION .z` -ilii °w� �ti.r r 'i`' t t +..y
J'3._�t�. �h°A'L�V �a�'�' ��?fi' :i+ �i e- v5'� t,a�'�rE'*f33:}�i'SI;_.'rr't2�.',�f'i
County Township T ' ' • ( ' ,town,township)
Parcel number L IIddescription I the property in question:
r7 N S�31-3-/0 / Real property ❑ Annualy 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 su nets that structure is used to produce income,desWte the use and portion
of the property utilized to produce Income.
a10-i93/ -(30 /-000. ZS4i -009
r :-- '"?y�;M _)s,�7:?-.y eaffiit• ' P:FT( PERTrY60 THER'COl1NTIEE t jt -S' kraiSk 77-Wr
County Township County Township
I hereby certify the above statements are true,correct and complete. Sign:tu of eh''
r-• // `•.aniGrr
Address(number and street,city state,and ZIP code)
E'
/0 . ...v/°7' "/L f X657-'21' - 1^-- £7 63 9
cfz;: "?-rvr3ht;*--....'-�.r r.:s.er" „'Ol'`7"i'? � AESSEDVALUE } OMESTEDv Y NONRESIDENIAL 1}
�rt GuS �SOR USE ONY� v�^k +mil f� AALUE A Ts100%OFiTrT,V�'z�adVALUE�'i ���42 . VALUE z-"=r .. _
Land
not exceeding 1 (one)acre immediately i `'surrounding residential improvements. (1) .-
Other land (2) -.. . . ..- ._
Total land(line f plus line 2) (3)
s
Dwelling (4) ek - a si f : y
Residential Improvements or Annually -
Assessed Mobile I Manufactured Home Garage (5) �€'r—.. ' i.f 4C,s'--.-...- .
T,f
Other improvements (6) ..-:`-y2---.!.--.. ° > ..
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 Data signed(month,day,yeah
and complete.
. Verifying action-Signature of Auditor Date signed(month,day,year)
§�.Y,yv„r+ - CY"-¢s+'3 zsY« .,..c1ti�y;r s�'�}a.-�STANDARO'DEDUCTION'ALL'OW ANCE+v:`4 ��'��ti,rt,..�,+ �,.,,a,,,�,r�_ ,w,�yeL`:s._
+rr.�e"�[a•-...."°�3 Y..��•+r7�... .:•Seas °S.S4.v:` A�._.-�- .� . _.... `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-hall(12)cd the nc acsed value of the mobile home or manufactured home.
Signature of Auditor -
Date signed(month,day,year)
. :t CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
4_::: —, STANDARD/ SUPPLEMENTAL DEDUCTION FORM
State Forth 5473(R13/12-09) HC10
..• nu:I Prescribed by the Department of Local Government Finance ° '
INSTRUCTIONS:See reverse side for filing instructions. - ,_
p_-�CERTIFICATION.N STATEMENT r7
I(We) LL ��M .1' �i«�i1 •I , I'��'��11 certify that I(we)occupied as my(our)principal
place of residence or am(are)buying the following described real(.perry for which a Homestead Property Tax StkardP6dugna is hereby claimed
under contract on the date this application is filed, _(date of filing). I(We): Y
❑ Own ❑ Am(are)buying under recorded contrail �)/` ��
❑ Am (are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation GIBSONN+ N y n
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified personal rresmence 1MQITOR
❑ Am (are)the shareholder, partner or member of the entity that owns the property.
• CLAIMANT'S INFORMATION -
If buying on contract.Fee Simple owners name
Recorders office where contract is recorded Record number Page
PROPERTY DESCRIPTION
Coo Township wn,townsh'.)A.
P I number Legal description Is the property in question:
(R-3I-30 I-o w a$*-O05 afteal property ❑ 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 is used to produce income,describe the use and portion
of the property utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County Township County Township
Signature .1 claimant
I hereby certify the above statements are true,correct and complete. / - <//
• mss .
Address(number and street,city,state,and ZIP code)
- •O 'VA it 7 a 4 ti657 T T^" 47639
ASSESSOR USE ONLY I TRUE TAX VALUE ASSESSED 100%OF THE I HOMESTEAD AD I NON- VALUENTIAL
Land not exceeding 1 (one)acre immediately
surrounding residential improvements. (1) .
Other land (2)
Total land(line 1 plus line 2) I (3)
Residential improvements or Annually f Dwelling (4)
Assessed Mobile I Manufactured Home Garage (5)
Other improvements (6) •
Total improvements(line 4 through line 6) (7) •
Total value (line 3 pits line 7) (8) >s
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)
STANDARD DEDUCTION ALLOWANCE
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-h (1 )of the assessed ue of the mobile me or manufactured home.
Signature f itor Date signed(month, y,mar)
LLI,0 (- 6-/!l