HomeMy WebLinkAboutHomestead_Vaughn (2) n" CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
se__. •� . STANDARD / SUPPLEMENTAL DEDUCTION
State Fonn 5473(R13/12-09) HC10
S ,01� 1' Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for tiling instructions.
z", � , CERTIFICATION STATEMENT . •_ - •
I(We) tiozet;\lI / A.ri . certify that I(we)occuple. as my(our)principal
place of residence or am(are)buying the following described real pr!erty for which a Homestead Property Tad ardp rppon is hereby claimed
under contract on the date this application is filed, (date of filing). I(We): IVU V 1 4 [1114
Own ❑ Am (are)buying under recorded contract
❑ Am (are) entitled to occupy as a tenant-stockholder of a cooperative housing corporation ��p (��I
pers
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a quaTiffE Nr1AAfttriOR
❑ Am (are)the shareholder, partner or member of the entity that owns the property. •
s_7-e-7O i CO�- NTRA¢TRECORDE6' -`�}es - _
v
If buying on contract,Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
.-. u ,__ -.f.` PROP,ERTN DESCRIPTION `T. s'•: . k ,. - - `?
Cou I Township Taxing district(city,town wnship)
P I number Legal de ption 1�--6���� Is the property question:
ot6-a 3-I(0-100-cal .9(to-oat ❑Real property ❑ Annually assessed mobile home(IC 6-1.7-7)
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.
- PROPERTYOWNEO;BY CLAIMANT INIOTHER•COUNTIES '---: - ,
County Township County• Township
I hereby certify the above statements are true,correct and complete. Sigha - • d.'mant a,7/�
Address(number and stre-t,city, ate,and ZIP...e)
- a . do - . h . 4771 .
` ASSESSED VALUE HOMESTEAD NON-RESIDENTIAL
ASSESSOR USE ONLY - _ :- -I._T�RUE TAX_V�UE :I>-:ATa100%.OF TTV-.L:�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) --
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)
- 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 6-7.1-12 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-h If 12)of the assessed value of the mobile home or manufactured home.
Signs e (Auditor • Date ffn :. rs —_