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HomeMy WebLinkAboutHomestead_Hicks (6) °'° CLAIM FOR HOMESTEAD PROPERTY TAX YEAR d__ 3 STANDARD/ SUPPLEMENTAL DEDUCTION FORM State Form 5473(R13/12-09) HC10 � 1 Prescribed by the Department of Local Government Finance INSTRUCTIONS:See reverse side for filing instructions. • _ rt S- o -// ilk° CERTIFICATION STATEMENT _ - I(We) �!te --� �7SS WII , certify that I(we)occu.°_•as I o 4 . ;cipal place of r, - or am(are)buying the following described real property for which a Homestead Property Tax Standafepduction is - -J. timed (,uunnder d on the date this application is filed, (date of(fling). I(We): CI 29 K I Own ❑ Am(are)buying under recorded contract L! rL�-J Am (are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation O)B°O '' ❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified personal -'.:r Win° ❑ Am (are) the shareholder, partner or member of the entity that owns the property. YA(y � �ITs _ t _ v T- - `-Y CLAIMANTSINFORMATION-� -: .' yl�. '��,a - • s ` l : .. - _s°� � _ ._ s.- -. „:_ If buying on contract.Fee Simple owners name Recorders office where contract is recorded Record number Page F... -� � - -- . . x,. - P.ROPERTY;DECRIPTION -_' ....71,7_ --f.'k^'.��'ta". 7 -. . . . �_ Cou / Township lid,'ct(city,town,township) I iCY0 rt-) �./&i'X� C� Parcel number Legal ption I Is the perty in question: �� / /Lt'/60 d g �I]v-l1 Real property ❑ Annually assessed mobile home(IC 6-1,1-7) If any portion of the residential structure or the land not exc eding lone(1)acre that imm tey surrou s that structure is used to produce income,describe the use and portion of the property utilized to produce income. a£-43-/7 tf03- WO. 000- 00Z,-- _ ,-_ - � ,.a,;PROPERTY OWNED;BY CLAIMANT INcOTHERCOUNTIES :,an _ - __.>$'r:_. . . .. ..:: County 1 Township County Township I hereby certify the above statements are true,correct and complete. Signature of G • nt x Addr-ss(number and street,city,state,and ZIP code) {� 17" are } ; /f 'ASSESSED VALUE HOMESTEAD NON-RESIDENTIAL ASSESSOR_USE ONLY_ _. u ITRUE ' VALUE I ATs100%OE.�TTVv� -I^ VALUE '�.fa Land not exceeding 1(one)acre immediately surrounding residential improvements. (1) Other land (2) Total land(line 1 plus line 2) (3) Dwelling (4) Residential improvements or Annually Assessed Mobile I Manufactured Home Garage (5) Other improvements (6) Total improvements(line 0 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 properly 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)