Homestead_Grabbe !""eq. CLAIM FOR HOMESTEAD PROPERTY TAX ! �!�i'.
STANDARD /SUPPLEMENTAL DEDUCTION ! ° {
State Form 5473(R13/12-09) r St
,� Prescribed by the Department of Local Government Finance / ` jl 9 2014
INSTRUCTIONS:See reverse side for filing instructions. /0�j1..e. . gf0(�/—Z 2 U
CERTIFI�CATION STATEMENT - ...
I(We) 1A...., 4—.1....t,. '4;0-e-n->! 14 4 G771� — )11.4eletr-eicd s"a"nse 1 :EKR4celiklilaYnALIID1TeRPal
place of residence or am(are)buying the following described real property for which a Homestead Property Tax Standard Deduction is hereby claimed
under contract on the date this application is filed, (date of filing). I(We):
❑ 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.
.. - --
- _
If buying on contract,Fee Simple owner's name
Recorder's office where contract is recorded Record number Page .
,i
._PROPERTY.DESCRIPTION : - -
County Township T •po district(city,town,township)
Parcel number Legal description � Is the property in question:
74 > oc�c �L Y� 7 ❑Real property ❑ 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.
01‘G-(9-19— 5f00 '' ooa. 36 9 -O l.6
- :PROP.ERTY_OWNED BY CLAIMANT IN OTHER COUNTIES: - _ _ .- - _ '
County Township County Township -,
I hereby certify the above statements are true,correct and complete. k..... \„/ ours of da n"^Lblx
`
Address(number and street,city,state,and ZIP�e)
4
ASSESSOR USE ONLY. TRUE'TAX VALUE ASSESSED VALUE HOMESTEAD NON-RESIDENTIAL- a
- _ . . - .. _ •.�,I�eATr100%:OF.TTV .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/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.
Ve Tying 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 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)