Homestead_Thomas a CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
. FORM
%S-.; STANDARD/SUPPLEMENTAL DEDUCTION FiCtO
f`° State Form 5473(R13/12-09)
Prescribed by the Department of Local Government Finance .
�e1�''''�"'�''r"'=Z#n'��'M'a�'�,�'�"���,j tratERTIF.ICAI'ION(STATE(v1ENfavii-^ See-.�"�±-���i.F�-> `.•
1(We) 44 a �r - �1� ae—a• certify thatl(wJ -.. •r.�asm 1. () -I
place of residence Jam(are)buying the following described real property for which a Homestead Property Tax Stan.:-. 0=I i.nasreyy h- t.-.
under contract on the date this application is filed, (date of filing). I(We):
❑ Own ❑ Am(are)buying under recorded contract AUG/I 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 é qualified personal resi e a trust
❑ Am(are)the shareholder, partner or member of the entity that owns the property. GIBSON C•
i I _2 ''`. ^s.... iahW' ' - CLA IVATsa'S lRNIATION':r '. - r ,. o„c<Sk S.dleo't,.�.14!u' i -. _
•.
� .��,� iy .�-^-,�,y�, :'� - CONTRACT RECORDED,y� .m?'
If buying on contract,Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
rSn' t are 5tarE:E is gr RO 71. 3E1SRITIO iati: 3".54. i�iVti :a-.lr-."r'.�"1�-.,
County Township Ta>- (city,town,township)
Parcel number Legal description ((//�I I Is the property In estion:
097 W SE /9- / - 9 a /nM, ❑Real property ❑ Annually 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 surrounds that structure is used to produce income,describe the use and portion
of the property utilized to produce income.
2 4 -06-i9 - x/ 00 '000 . 7 70 - O / 7
-3fi- ^p'F-3 mss. s bi- ,watt;-.._. +k. +Y `vc ♦rri. m� t"-4,0
��ax1��_+"e'z'.�r� „�sF„sr,_PROPERTIY,�OWNED BYJCLAIMANTjIN;OTFiER COUNTIES_j,�+'.(j.- , ,._wore.�:t,,, _;,{ �_-��«�,-:
County Township County Township
I hereby certify the above statements are true,correct and complete. Signature of claimant
2r7 & a- '
�/ Address(number and street,city state,and ZIP code) '
7� /(0 6 C o n/ t_� .., 1 -76,
5c y - -,r: . _ ua ar fa ffT ys yt}g5:7.J� �e> i3Y1C-c7'TASSESS ED tVALUE,I{d'en6MESTEAtiPleiatIn6N RESIDENTIAIy,�,.-'._
?4,.: t�ASS S FOR 11SE�ONLYyr 1a Y ASSlyTRUE3TAXrVAL'UE• ATai1 Dow 0EarirEVeiter-.ri),VAilu Ert..•l:4A.-61,3-7 ALUE ;t'A`d--.'?5=^.-
Land not exceeding l(one)acre Immediately ' .1 " _ ',-3-a,,,,.,
surrounding residential Improvements. (1) ,: ' ` °_ '
`q
Other land (2) .� -._
Total land(line 1 plus line 2) (3)
Dwelling (4)
Residential Improvements or Annually '9,-:: ,-
Assessed Mobile I Manufactured Home Garage (5) _ _E-_. -...r,- p
Other Improvements (6)
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 Date signed(month,day,year)
and complete.
Verifying action-Signature of Auditor Date signed(month,day,year)
t ^ " e jtikaa g a STANDARD 1 E DUCTIOtALLWANCE P 2 , ? g?i1t;:, E iav:%
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 pmvided 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.
Sgra re of Auditor Date signed(month,day,year)