Homestead_Birge a CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
” jA STANDARD A I SUPPLEMENTAL DEDUCTION OR
4c
'' Prescribed by the Department of Local Government Finance
•
INSTRUCTIONS:See reverse side for filing inshuclions.
i rs�'t ��,�x �"c` h F3n CERTIFICATION Sf aFONT T2 as �iY Lt .'t.l °a '�u•Ia2 5.5:'1'1,
I(We) 11i�I:n.I�� certify the( L a •. papal
place of residence or am(are)buyi e following •- cribed real property for which a Homestead Property Tax S n a D uctio is�e aimed
under contract on the date this application is filed, (date of filing). I(We):
❑ Own ❑ Am(are)buying under recorded contract JUL 2 5 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 re ••ence trust
❑ Am(are)the shareholder, partner or member of the entity that owns the property. Wiring
.i.-a y .;,rx�+rSciI e.tATIO err end br a. '_^+1 a:i:aM2-- iy;x��� Y_ �r
-��,r�' 3 .y�"�'�,�•+� �;'�py^�;��LAIMANT;SIINF,ORMATION ��„a.�-�-na'�` 4.z:�3'���M�Ae?&t��h's�t�t1
...
ti% �� '*..tee''pct` -"-`�'ry.iac--.5tt`+cr _ONTRACTIRECORDED41�`a-' -`s�•-`c='^ L:w :.naat5 �::nd.Y'.i. irt`�.!` a:
If buying on contract,Fee Simple owners name
Recorders office where contract is recorded Record number Page
S= ` t ?ROFIERTZDESCRIPjla r�'' r r„ -� ?i. r
s�`."�'a.-°xS� � �.3'aa.s.�.r�- I.n+...,>? a..t.'a £�a.'� `.
County Township Taxing district(city,town,township)
Papa/number (( Local de'irv' Is the property in question-
A • , -a l-�o -.00o_o4s- oa o ❑Real property ❑ Annually assessed mobile tome(/C 6-1.1"7)
If any portion of the residential sbu•' re 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.
4`"mod` k ;" "E a, 1 PROPEik7:53WNED1BYjC AIMANT INfOTHER COl1 Off IESi: g*- t&rii:4 _Yiai t:
County Township County Township
I hereby certify tie abg�ve statements are true,correct and complete. signs • da ant /J
Address umber and street city state,and ZIP code)
irti ccs • 1174° 976a
fi4 r.xr-k-Ew v" wmira t': `'Y-"5'+ -"` met' d wrtASSESSED VALUE:I;-EHOf4ESTEAD`r . NON RESIDENTIALY3+�,ip,
r gSS_E SOL R U�SEyONLY y. x `' ,tri TRH-Aa.,/is.,.. i ttAT3100%.*OFeTirMAtitigkiNALUE+ ea'�5.1• :41PAI I VALUE ZS-_ 2v-_.'`.-}
Land not exceeding l(one)acre Immediately (1) ''�
surrounding residential Improvements. - - -
Other land (2)
Total land(line 1 plus line 2) (3)
Dwelling (4) '•-- ry a.'F :.�- 's.
Residential improvements or Annually
Assessed Mobile/Manufactured Home t'iarege (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,lead
and complete.
Verifying action-Signature of Auditor Date signed(month,day,year)
r-°-'+?tyi"Z't epfaCaalleg ai-si•{"a y!r' *PSTANDARDJDEDUCTION, LOWNCE,�,�? F_ a+'L,e,�`�=_ fig�e-tl•-ral...v
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)