HomeMy WebLinkAboutHomestead_Frederick (2) <An" CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
4:". STANDARD/ SUPPLEMENTAL DEDUCTION FORM
State Form 5473(R13/12-09) HC10
> Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for filing instructions. j'/ Z /a 0 a _ 'a 7 0•
,,//�� - - CERTIFICATION STATEMENT
I(We) . ' A/
- a C / certify that I(we)occupied as my(our)principal
place of residenc'or am(are)buying the f owing described real property for which a Homestead Property Tax Sta a e ctionnraimed
under contract on the date this application is filed, (date of filing). I(We): 1��••--((
❑ Own ❑ Am(are)buying under recorded contract
❑ Am (are) entitled to occupy as a tenant-stockholder of a cooperative housing corporation OCT S Z014
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified personal residence trust
❑ Am (are)the shareholder, partner or member of the entity that owns the property. ,
' ., - "tCLAIMANTS INFORMATION, - 7t., __ ,
v=z - >< _CONTRACT RECORDED_ ` 1
If buying on contract,Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
.1
!r-PROPERTY DESCRIPTION - - - -
County Township Taxing district -4/ct wn
town,tosh i� ,
Parcel number Pr description Is the property in question:
r1 M O 1 N / 1 o I. 7 95,f-c ❑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.
a(0 - o 1-_ Sg .- o icf -OD 3. 0 , 5 - 0/6
PROPERTYA WNED BY CLAIMANT pi OTHER COUNTIES - _
County - Township County Township -
I hereby certify the above statements are true,correct and complete. ignature of clai nt . `
Address(number and street,city,state,and ZIP code)
N at le. e n TN LI ca Zo
ASSESSOR USE ONLY _ _ rTRUE TAX VALUE' AAT_�E00%OF_.TTrE I .H�VALUE, I NON-RESIDENTIAL
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 4 through line 6) (7)
Total value (line 3 phs 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(1R)of the assessed value of the mobile home or manufactured home.
Signature of Auditor Date signed(month,day,year)
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