Homestead_Kingsbury (4) CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
4_.wa STANDARD(SUPPLEMENTAL DEDUCTION FORM
�yy State Form 5413(R1515-14) HC10
`;'?,-%` Presmbed by the Department of Local Government France
INSTRUCTIONS:See reverse side for Ring instructions.
NOTE:Telephone,Social Security,driver's license,state identification and federal identification numbers are confidential under IC 6-1.1( 7 i I D
(w )4 an ► - /_ !T .
I e La Q �4s�— certify that I(we)occupied as my(our)principal
place i residence or am(are)buying the following described reaproperty un•Q.• act for which a Homestead Property(�8f1a
Dedu on is hereby claimed on the date this application is sign-•, (date of signature). Y(av):'! 114
f9§T Own. ❑ Am(are)buying under recorded contract.
❑ Am (are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation. �py/ �-�/�
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified pQ l ishEe NEZr9elNL(A.p . .
❑ Am(are)the shareholder, partner, or member of the entity that owns the property. �+�U AUDITOR
Recorders othce where contact is recorded Record number Page
. .,: ' & t - aST�..7- .PROPERTY.DESCRIPTIONci-733; r.1_ _ `_j.
Cony ,Township T. "El tie tit town,township).
Parcel number Legal desscn ion //// / I Issthe9rprotterog in cuerim
/O�� ' ^I Qs _ //LlReal property ❑ Annually assessed mobie home(IC rift-7)
a any po.^ion of the residential=care or the land note exceeding one(1)acre that 4r. tey surrounds ds tatstructure is used to produce income,describe the use and poron
CI tie property triad to produce come.
Z4- 4? -3t-J0o -o0a . h.01 - ° H
PROPERTY OWNED ELSEWHERE BY CLAIMANT
San.County,and Township Is claimant vacating a homestead?
❑ Yes ❑ No
K S�azure uram
� `' I hereby certify the above statements are true,correct,and complete. /�
Mtr P i Address of=tact(number and street,oly Sete,end ZIP code) I PL of vacated h mesead ,y(nu street,au Sae,end ZIP ttge)
36 S. ?I've., a.lf tor. 1 ?63
Land not exceeding one(1)acre immediately I(t)
surrounding residential improvements
Other land 1(2)
Total land(line 1 plus line 2) (3)
Residential improvements or Dwelling (4)
Annually Assessed Mobile I
Manufactured Home Garage (5)
Other improvements 1(6)
Total improvements(line 4 through line 6) I(7)
Total value (line 3 plus line 7) l(e) 1
I hereby certify the above is true,correct, I Signature of Assessor I Date signed(month.day.year)
and complete.
Vamtyingacm-Sgnataed Auditor I•..t- -e lima-M.1-x%;
t t
(l I I ' i
-2"E-4„_ _ ..� _r STANDARD DEDUCTION ALLOWANCE Lr:s--IF ?tj' . ;..+'A-S.
20.43 pay 20/c Lesser of 60%of the assessed value of the homestead or 545,000 DEC 19 Z014
Not SP.hstandug any other provision,the sum of the deductions provided in IC 6-1.1-12 to a mobile home S
that is not assessed as real property or to a manufactured home that is not assessed as real property may
not exceed one-half(1/2)of the assessed value five mobile home or manufactured home.
i
Sgnaare of iYuz( Dr sit. A - e+k
�ip.
* ' ,
DltpR
nisi. ' • I
DISTRIBUTION: Original-CoumyA:d.tor,Fie-Samped Copy-Taxpayer