Homestead_Dehosse 0 YEARniv CLAIM FOR HOMESTEAD PROPERTY.TAX
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STANDARD/SUPPLEMENTAL DEDUCTION FORM
State Form 5473(R13/12-09) HC10
�' � 1 Prescribed by the Department of Local Government Finance - _
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INSTRUCTIONS:See reverse side for filing instructions.
/j- 0 /, CERTIFICATION STATEMENT - •I(We) f /y ,' al Air' 4, t.2.—' certify that I( as ur aincipal
place of residence or am(are)buying the following described real property for which a Homestead Property Tax Stan as lion i re. I ed
under contract on the date this application is filed, (date of filing). I(We):
Own El Am(are)buying under recorded contract JUL
❑ Am (are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation 18 2014
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified personal res.:ence trust
❑ Am (are)the shareholder, partner or member of the entity that owns the property. I ,
CLAIMANT'S INFORMATION _
If buying on contract,Fee Simple owners name
Recorder's office where contract is recorded Record number I Page
PROPERTY DESCRIPTION
County Township Taxing distngt(city, r wn,t ship)
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Parcel number Lea decr�nti,n, n .t, yi7 • .perty in question:
( / �J4) 4,2-/-/C.) 'ed Real property ❑Annually assessed mobie home(IC 6-1.1-7)
If an potion of the residential structure or the land not exceeding one(1)acre that immediately su •s that structure is used to produce income,describe the use and portion
o, perty utilized to produce income. 4, e1 7 c5— .
rg-Do?-.S9 5g -odo./a�o/9
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County Township County //�1 Township
I hereby certify the above statements are true,correct and complete. Signature o(daimant 0e5
••dress(n mbar and street,city,state,and ZIP code)
- a r e d ar AZ e ti) Ire (-l7 Co Y J
ASSESSOR USE ONLY I TRUE TAX VALUE I ASSESS
AT 100%OF TTV HOMESTEAD I NON- ESIDENTIAL
Land not exceeding 1 (one)acre immediately
surrounding residential Improvements. (1)
Other land (2)
Total land(line 1 plus line 2) (3)
Residential Improvements or Annually Dwelling (4)
Assessed Mobile/Manufactured Home Garage (5) •
Other improvements (6)
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)
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-half(1/2)of the assessed value of the mobile home or manufactured home.
Signature of Auditor Date signed(month,day,year)