Homestead_Kelly f'a; z' CLAIM FOR HOMESTEAD PROPERTY TAX `i ;:��.`=
STANDARD/ SUPPLEMENTAL DEDUCTION F=RM
HC10
^sue.•.'•.��= State Form%73(R13/12-09)
` Prescribed by the Department of Local Government Finance J 1 6 014
INSTRUCTIONS:See reverse side for filing instruct4ons.
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certify afaaSe l�r ®r t
I(We reiPM71I lAt � r
place of residence or a •,re)buying the following described real pro y-rty for which a Homestead Property Tax Standard Deduction is hereby claimed
under contract on the date this application is filed, (date of filing). I(We):
1111.• ❑ Am(are)buying under recorded contract
g 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 qualfied personal residence trust
❑ Am (are)the shareholder, partner or member of the entity that owns the property.
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� �t�gr�,�*�y���, ' ;'�'t��y�"�-�,��, �� CLAIMANiTzSjINFORMATION& -'��t�a:,n*.Rz�Sa�>L;:k�:SAei�'47...sxy-��ri!
If buying on contract,Fee Simple owners name
Recorders office where contract is recorded Record number Page
`ia.1r'N-.a�ski. 'Sid-- •: � r ,—Crab,£F� fzROP,E ITt D TCRIP,TION -Fo pftr'O �,�,µ ti-- c ' `$'3 i42-a
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County Township
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Parcel number Legal description Is 6�1mC ;in question:
a b-\.-t - o; -At)b, o . \L 5 - k
❑ Annually assessed mobile horse(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 properly utilized to produce Income.
��x:-a Y a n- yl�S�us. °PROPER Y'OWNE CLAIMAh NIOT,HERCOLINTIig1,W f'RRSt,".`_'" Ci i iii)i
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County Township
I hereby certify the above statements are true,correct and complete. /
Address(number and street,city,state,and ZIP code)
• 5o -✓e ,✓a Dog-A/51/244e�ce 7d / v7466
sr-r.° A.�,w"w...5isz?biu::4 °FS.+r.v_k_fvi rs'�Vii --. -..,..-._ -'Y e� ;ice
.-41 SSOR w`O OLNl3tL �' ril1E'TAX-VALU !'ASSESSED VALUE:I HOMESTEAD a _.`ANON RESIDENTIAL' ` ;'•
4 �i.�1 �;`g. �.y- '�, lUE4 limiloocaOaiiraw ti vAlit1EUS i.. :>xa�-:4.11AbacuE 3 .s
Land not exceeding 1 (one)acre Immediately (1) -.--tit r _,';
surrounding residential Improvements. >
Other land (2) .,_..
Total land(line 1 plus line 2) (3)
Dwelling (4)
Residential improvements or Annually - :1 r .., ..
Assessed Mobile/Manufactured Home ' t-.E - t --9
Garage (5) z � ?s1''X r , a;
Omer Improvements (6) ;` c';'r.2,V,-.f;-C.:
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)
la .t t -ss•+=- yy,; i'-4,11'' ' rs. STANDARD DEDUCTIONrAL`L W a,E` r"'sK r 4`Z4—::Y`' ' �` •`. fi
�' �v".�-`�:5's�:§� y�a�it.«ai:s'�'�s�Yec�� y�.. _.»i;76�-'�-�4 .s3a._- �.>,5.:c`-t��.' -a:-Ki'vvs`'1�zrS`
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-I.1-12 to a mobile home that is $
not assessed as real property or toe manufactured home that is not assessed as real properly may not exceed
one-half(12)of the assessed value of the mobile home or manufactured home.
Signature of Auditor Date signed(month,day,ye r)
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