Homestead_Mann "'"ra CLAIM FOR HOMESTEAD PROPERTY TAX ' i YEAR
_ :.`
:;_. STANDARD /SUPPLEMENTAL DEDUCTION iyo
State Form 5473(R13/12-09)
°' , Prescribed by the Department of Local Government Finance NOV 131014
INSTRUCTIONS:See reverse side for filing instructions.
CERTIFICATION STATEMENT. a
c,a I(We) - • _ \t. �- i�L .►� ce .e r'v" ne.• £d iy(our)principal
place of re e.ence or am(ar I: ying the following described real property for which a Homestead $'.ax tandard Deduction is hereby claimed
under contract on the date this application is filed, (date of filing). I(We): �� ,1 /
Amn ❑ Am(are)buying under recorded contract g/a Oj/ 6
(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation VVVV
❑ 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.
- . r-.� ...e . -.,CONTRACT RECORDED-_`: - n..": _F_ -7:7%; . _- ,_.._.
If buying on contract Fee Simple owner's name
Recorder's office where contract is recorded Record number I Page
i• - -- _- ,P.ROPERTY-DESCRIPTION. . ;. - " - - T-''
County Township I Taxing district(d ,town,township) -
Parcel number Legal description I Is the in question:
Pt S ‘.5? 3D- 3-A0 �a tIIII eal 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 to -,9-3G- -Vac 0 6. . 0 7 7-0,2 S S -
__ -. __. -. :ysPROPERTY OWNEDBY CLAIMANT IN OTHER COUNTIES-_ _-_- • - _ "_ -. .
County I Township County Township
I hereby certify the above statements are true,correct and complete. Signature imam
Address(number and street,city,state,and ZIP code) -
9i ( c °lzc s �Qjbs-+ 1A- )tJ 11-76 -
ASESSED VALUE HOMESTEAD " - NON-RESIDENTIAL
ASSESSOR USE ONLY . .+t. TRUE TAX VALUE ,,AT'100%OFTTTV✓,- -t o 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 0 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)
- '-;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-f.1-12 to a mobile home that is S
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 Audito �� Date signed(month,day.year)