HomeMy WebLinkAboutHomestead_Meredith ziaCLAIM FOR HOMESTEAD PROPERTY TAX �� FORM YEAR
1 STANDARD /SUPPLEMENTAL DEDUCTION I HC�o
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State For m 5473(R13/12-09) F,u Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for filing instructions. N�V.11 2014
- - - CERTIFICATION STATEMENT- - -
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I(We) • ' L � h e7 h m e r e 1 �" tl?yliy; 'fy that I(we)occupied as my(our)principal
place of residence • am(are)buying the following described real property for w §12binciaLl8JirtelpkiDgpreOndard Deduction is hereby claimed
under contract on the date this application is filed, (date of filing). I(We):
S Own ❑ 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.
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If buying on contract.Fee Simple owners name
Recorders office where contract is recorded Record number I Page
_ .- , .-f. - -,- .;_QROPERTY DESCRIPTION. -- -- _ -:b r. r.._; 4 _ •"k;
County Township Taxing district(/p/ty� to ,tttownship))
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Parcel number e9 saipti n p �) I Is the i�fifrr yy in question:
A D O a-/-/ /Real pro perty Annually assessed mobile home(IC 61.1-7)
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.
R / -05 -57- C 3 co3 700 o/ -7
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_ . _ �_ _ t- ti__ __ ._.- __ ...... a_
-- • .g, ., ,, -`-PROPRTY30WNED BY CLAIMANT IN OTHER COUNTIES , -_ ,; -
County I Township County Township
hereby certify the above statements are true,correct and complete. Signature of=mart
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Address(number and street,city,state,and ZIP code) p 1 A , ( l (/
4F5f S-1,+ ' Ro..c� 5-6 r-l4Ze(4C -1-4-) -I 2 � l o
ASSESSED VALUE HOMESTEAD NON-RESIDENTIAL -
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AS SESSOR USE ONLY- - ,--.4-mom- TRR E TAVALUE ...AT100 yo:OFITV a.�:.VAL•UE-
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 plus line 7) (8)
hereby certify the above is true,correct, Signature of Assessor Date signed(month,day,year)
I and complete.
Verifying action-Signature of Auditor Date signed(month,day,year)
- '- STANDARDDEDUCTIONALLOWANCE •
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-half(12)of the assessed value of the mobile home or manufactured home.
Signature of Auditor Date signed(month,day,year)