HomeMy WebLinkAboutHomestead_Manuel (2) CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
R STANDARD/ SUPPLEMENTAL DEDUCTION HC10 /J/
\� State Form 5473(R73/12-09) /7
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, Prescribed by the Department of Local Government Finance
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INSTRUCTIONS:See reverse side for filing instructions. 1 • • , ?/e /_3'e '?
CERTIFICATION STATEMENT co `J
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I(We) S e 1 Q Q /) t4 e / certify the a a...S,tie principal
place of residence or am(are)buying the following described real property for which a Homestead Property Tax da J. a duct h; ;.aimed
under contract on the date this application is filed, (date of filing). I(We): .
Ecirm n ❑ Am(are)buying under recorded contract NOV .12 2014
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 r idence trust
❑ Am (are) the shareholder, partner or member of the entity that owns the property.
!.,-"k7:`_ $u-`.t in.'r.'-.4 ;CLAIMANTS,INFORMATION'_,__fl - 1 -'-. r aCr is
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If buying on contract,Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
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- _;-i;. - • PROPERTY DESCRIPTION - -County Township Taxin dis ' ity wnship7—/�—'
Parcel number Legal description Is the property in question:
❑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.
ZO— /J-76,—/OO — CO /- a 3 L -d
PROPERTY OWNED By-CLAIMANTIN OTHER COUNTIES - -
County Township County Township -4
I hereby certify the above statements are true,correct and complete.
Signature of claimant
Address(number and street,city,state,and ZIP code)
ASSESSOR USE ONLY�. _ ,r TRUE TAX VALUE. AAT 100 E OF._T.TVE,I H�VALUEAD I NON-VALUENTIAL
Land not exceeding 1(one)acre immediately a
surrounding residential improvements. (1)
Other land (2)
Total land(line I plus line 2) (3)
Dwelling (4)
Residential improvements or Annually
Assessed Mobile/Manufactured Home Garage (5)
Other improvements (6)
Total improvements(line 4 through line 6) (7)
Total value (line 3 pits 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)
ARDIDED
STAND UCTION ALLOWANCE
20 pay 20 Lesser of 60%of the assessed value of the homestead or$45,000
Nohvithstanding 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(112)of the assessed value of the mobile home or manufactured home. -
Signature of Auditor Date signed(month,day,year)