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HomeMy WebLinkAboutHomestead_McEllhiney • art ., CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR °_ STANDARD /SUPPLEMENTAL DEDUCTION OR State Form 5473(R13/12-09) '-, . Prescribed by the Department of Local Government Finance INSTRUCTIONS:See reverse side for filing instructions. :_. • ,•,-,N CERTIFICATION,STATEMENT I(We) Ali li 1 r. s rilKJ"P)_ -- — IFIPIS certify that I(we)occupied as my(our)principal place of residence or am(are)buying the following de-f•ed real property for whi • a Homestead Property Tax Standard Dednctign is toy claimed under contract on the date this application is filed, (date of filing). I(We): U 1, 1 LU I4 ❑ Own ❑ Am(are)buying under recorded contract �� �1/�� ❑ Am (are) entitled to occupy as a tenant-stockholder of a cooperative housing corporation ` jyt� ❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified persoQIi&&idnGe,QMMTY AUDITOR ❑ Am (are)the shareholder, partner or member of the entity that owns the property. - _ - , ,. : - - - _ • If buying on contract,Fee Simple owners name Recorder's office where contract is recorded Record number Page . s - - c- .P,ROP.ERTY DESCRIPTIONp,'. a . z - _- - .` County Township Taxing district(city,town,township) - jarcel rinmber / 'j_['y� Legal description Is the property in question: ((-I f4 - o -cL )- LS b ❑Real property ❑ Annually assessed mobile home(/C 6-t1-7) ii If any portion of the residential structure or the land not exceeding one(1)ace that immediately surrounds that structure is used to produce income,describe the use and portion of the property utilized to produce income. _� -- _, . _�. w . - •.• - - - PROPERTY OWNED BY CLAIMANT INbTHER COUNTIES • - s• County Township County Township I hereby certify the above statements are true,correct and complete. S, i9ga�- •f laima A/ x / -4, - Add -ss(number and street,city,state,a • IP code) I if a ; as . ,1 . , . , . 1 ?(OY • U ASSESSOR USE ONLY - e ?I TRUE TAX-VALUE "ASSESSED VALUE I -HOMESTEAD I NON-RESIDENTIAL - . s U AT-100%OFcETV VALUE VALUE 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 I Manufactured Home Garage (5) 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) ` 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-i.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-hall(12)of the assessed value of the mobile home or manufactured home. Signature of Auditor Date signed(month,day,year)