HomeMy WebLinkAboutHomestead_Wilmes CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
lb:—� STANDARD I SUPPLEMENTAL DEDUCTION FORM
Ip Sate Form 5473(R15ISt4) HC10
- I Prescribed by the Oepar.mem of Local Government Finance � _
•INSTRUCTIONS:See reverse side for filing instructions �1 `� k'
NOTE:Telephone, • -.I Security,driver's license,state identification and federal identification numbers are confide 1 end IC 6-11.12=37. . r
.. •i( "/Y' f , t_ ii CERV•TIC/�hnN STATEMENT : - - '- •, _ ..
I(VVe) tsani-rent`' i(/_� es certify that I(we)o d9sgl 14 principal
place of rest ence or am(are)buying the following. bed real property under contract for which a Homes ea o ndard
Deduction is hereby claimed on the date this appli r on is signed. (date of signature). I(We):
❑ Own. ❑ Am(are)buying under recorded contract.
❑ Am (are)entitled to occupy as a tenant-stockholder of a cooperative housing corporatiorGlBSnnN couMTyyee'�'�F��T�Tl1
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qua ified persona rdsitl2Mk'SrUSf,R
❑ Am (are)the shareholder, partner, or member of the entity that owns the property.
_ • - i
$ {_//`(__ _ = „r• _"CONTRACT.RECORDED:C„'x-ceia
If Ursine cc con}ac,Fee Simple carrels name
Recorders oSce where con•.raa is recorded Record number Page
".ir-A�h)7Ze- — .{z ._.� _.-•-Yl- x�- 6M-;.PROPERTY DESCRIP770N _Cr ti;' i�1 ?s_. `''+�.�` �..'�..'-i:-
`4'1a 4
, Town coo Taxing district mty.1. J# I
P /�_unbeg x'� L I eesai�on Is the property i testa,'
t r es 300190a r Real property ❑Annually assessed motile Mme(IC 6-1.14)
If any portion of the residemial sMLre or the land not eaceedig one(1)acre that i Mediateh eattu that structure is used to produce income.desaiibe Use use and non=
of the p opety varied to produce income.
PROPERTY OWNED ELSEWHERE BY CLAIMANT
Sode,Corny,and Township Is claimant vacating a homestead?
❑ Yes %No
S*av davnam
I hereby certify the above statements are true,correct,and complete. t / 1
mess of contact(number and street.01y,state.ant ZIP code) Address of vacs: d,d a number and street sly state.and ZIP code)
`j1� X I =f2V11 Nat.495k 4- IN b
Land not exceeding one(1)acre Immediately I(t)
surrounding residential Improvements
Other land 1(2)
Total land(line 1 plus line 1) (3)
Residential Improvements or Dwelling (4)
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)
I hereby certify the above is true,correct. Signature of Assessor Date signed(magi',day,year)
and complete.
Verifying action-Signature of Auditor Date signed(month,day,year)
STANDARD.DEDUCTION'ALLOWANCE C,W2A`..s_; ' .>-{=y'--a•_a t
20 pay 20 Lesser of 60%of the assessed value of the homestead or 545,000
Notwith- nding any other provision,the sum of fhe deductions provided in IC 6-1.1-12 to a mobile home $
that is n a assessed as real property or to a manufactured home that is not assessed as real property may
not ex x •o e-hatf(12)ol the al.essed value of the mobile home or manufactured home.
Sgmuar •t. �•tw Date signed(m iSt,day.year)
li �a-��
DISTRIBUTION: Original-Conroy Auditor,Fie-Samped Copy-Taxpayer