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HomeMy WebLinkAboutHomestead_Skaggs CLAIM FOR HOMESTEAD PROPERTY TAX YEAR ...a...4pp_���, ) STANDARD / SUPPLEMENTAL DEDUCTION FORM r v' State Form 5473(R13/12-09) HC10 Prescribed by the Department of Local Government Finance INSTRUCTIONS:See reverse side for filing instructions. 8/L/ 38.51. 6 374 ir-, -- - Mr! -Pr% CERTIFIC•TION � ` I(We) a ice., �- /i certify that I(we)ocalpied as my(our)principal place of residence or am(are)b•(Ing the following d-scribed real property for which a Homestead Property Tax Ste d-D@edµct(oq's hereby claimed under contract on the date this fplication is filed, (date of filing). I(We): I 1 I (!��u ❑ Own ❑ tenant-stockholder(are) ckhol under oft recorded contract �r ❑ Am (are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation r ❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified�l 6�dr€seeliatht@tUDITOR ❑ Am (are)the shareholder, partner or member of the entity that owns the property. „ If buying on contract,Fee Simple owner's name Recorder's office where contract is recorded Record number I Page ,I ,'PROPERTY DESCRIPTION County Township Taxing district(or township) Parcel number Leg esmption L/_. s_ I Is the property in question: �� S P n ❑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 i mediatey surrounds that structure is used to produce income,describe the use and portion of the property utilized to produce income. C' aCo-td.- o7 - X03- ooi. 593 - o }- b I - _ PROPERTYOWNED cpsocifam OTHER COUNTIES County Township County Township ., I hereby certify the above statements are true,correct and complete. Signature of FIaimant . Address(number and street,city,state,and ZIP code) ) k ) 4i ,R c 1 ,Pr,„, eP. x f-A— l/ 74.17 0 ASSESSOR(Mar TRUE TAX VALUE I ASSESS/D VALUE I HOMESTEAD I O NON-RESIDENTIAL Land not exceeding 1 (one)acre immediately surrounding residential improvements. (1) Other land (2) Total land(line 1 plus line 1) (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 plta 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) • I 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 property or to a manufactured home that is not assessed as real property may not exceed one-hall(1/2)of the assessed value of the mobile home or manufactured home. Signatur oft ;: ,�✓W - Date signed(month,day.year)