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HomeMy WebLinkAboutHomestead_Sullivan °'° CLAIM FOR HOMESTEAD PROPERTY TAX -r,YEAR STANDARD / SUPPLEMENTAL DEDUCTION F' ` .0•State Form 5473(R13/12-09) 1 0 ME s''''-4-4---", Prescribed by the Department of Local Government Finance + - 5 INSTRUCTIONS:See reverse side for fling instructions. NOV 5 2014• `n CERTIFICATION STATEMENT - I(We) ��� f/Ar"�///V�'»I_ _ 4/ _ certify that I(we)occu a (,;.nndpal place of.t�id i�O or (are)buying the following described real property for which a Homestead Property Tax Standard_r��)'(3r�', tplefktlifagiGIR under.•tract on the .ate this application is filed, (date of filin I GIBS PP ( 9) M/e) gOwn ❑ Am(are)buying under recorded contract ❑ 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 a qualified personal residence trust ❑ Am (are)the shareholder, partner or member of the entity that owns the property. - z s ' ss•_tY_-. - /J •%, ;CLAIMANT'S INFORMATION;_ `jw. 7,1 ti._. U2-+ :`" 7", . e. NCONTRACT.RECORDED_d; .- • - .:'- If buying on contract,Fee Simple owner's name Recorder's office where contract is recorded Record number Page ,I - PROP,ERTY DESCRIPTION- b County/0 Township 1 Taxing dist•ct(city,town,township) ,�,, / Parce number Legal description I Is the rty in q on: 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 surroun s that structure is used to produce income,describe the use and portion of the property utilized to produce income. 86- 02-2 -60() -003• 113D,-Oil - :•- PROPERTY,_OWNED BYCLAIMANTINOTHER COUNTIES -.F:r - - County ' I Township County I Township -_ 1 Signet of claimant ` I hereby certify the above statements are true,correct and complete. y_ L� ���, � Address number and street,city,st.te,a • 'IP.••e 1 \ J'� • AF VI LEI i _/ill _ _4S ' // U b rr I ASSESSED VALUE HOMESTEAD ° NON-RESIDENTIAL ASSESSOR USEONLY rTRUE TAXNALUE 9._AT.100%OF f- , .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/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 6-1.1-12 to a mobile home that is $ not assessed as real property or to a manufactured home Mat is not assessed as real property may not exceed one-half(12)of the assessed value of the mobile home or manufactured home. Signature of Auditor Date signed(month,day,year)