Homestead_Hunter (2) t% CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
\ STANDARD/SUPPLEMENTAL DEDUCTION FORM
i{���. Sate Forth 5473(R15IS14)
•.'•4-!t Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for filing instructions. 1
NOTE:Telephone,Social Security,drivees license,slate identification and federal identifrcafion numbers are confidential and-!I • 1.:12 I . I - r
CERTIFICATION STATEMENT • -_ _----4-_ _,,-.t ,e,r1 , 1.f.
� J
/�/�// '�/ r/� /.
I(We) 41117_ (//'��. /�=I/���!i / certify that I(we)occupied as my(our)pnn
place of residence or am Ire)buying e following described real property under contract for which a Homestea`O,Lert,T x Sandard
Deduction is hereby dal.ed on the date this application is signed, (date of sgnaturef., 1 0014
g Own. ❑ Am(are)buying under recorded contract. 7
❑ Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation. G./pp ',. •7/ d
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a nugget* •'- r 4 ,y trust.
❑ Am(are)the shareholder, partner, or member of the entity that owns the property. Nry qU
_ -- _ OLAIMANT'SINFORMATION- . __ - -
-._ ,
If toying on contract,Fee Simple owner's came
Recorder's otce where contract is recorded Record number Page
ri._.a '.'?-.. • '>s..r&-.. . ---. . y.:17.'73 PRO PERTY,DESCRIP.TION '_.-ji:_a=' �. �' at •.r:.•-�
Cathy- Township T My town P)
/ eter
sters: LJ
umber neg� pSon �0 Is t�he,pro Iprin guesdon
/7644, he pr eat pmpery ❑AmuaPy assessed moNe borne(IC 6_1.1-7)
If m Jon of the resilercal structure or the .ed not esae()aos u+aryt y rely sun un that Cunure is used to produce iim.ni..desmbe the use and portion
va red to podia intone. /y '.
4.79_79-/o/... 0649579_x2
PROPERTY OWNED ELSEWHERE BY CLAIMANT
1 Sate, and Towp Is claimant vacating a homestead?
❑ Yes 0 No
ignature of Claimant
I hereby certify the above statements are true,correct,and complete. I M e`
Address of contact(number and greet nay,Sate,and ZIP code) ti 7 r4 Address of vacs: homestead,d eny(number cirri &coy Sate,cirri ZlPmde)
I C77 S. 't Os Vb Co. G`-, Z V\
Land not exceeding reside one m)acre irensdiataty I(t) n/
Land not ex ee iing onl Improvements �i/�Jy/1/Wa 1
Other land 1(2) a e // 5
d
Total land(line 1 plus line 2) 1(3) ',nal �v g4V =/ i' 6
Residential improvements or I Dwelling I(4) ,
Annually Assessed Mobile f � �` �
Manufactured Home Garage (5) �G///e v ll�. el. 77 7
Other Improvements (6) '/n, y/w/,_ _w /a-3/-/c‘ O+
Total improvements(line 4 through line 6) (7) 04641;71&-E:14641±1
Total Total value (line 3 plus line 7) ((e) I
I hereby certify the above is true,correct. (Signature of Assessor Date signed(month,day,real
and complete.
Verifying action-Signature of Nd:tor Oats signed(month,day.year)
Mt S -'i`-= " . - -x'34 7 STANDARD DEDUCTONALLOWANCE- S. —d`e--rrO- "e
20 pay 20 Lesser of 60%of the assessed value of the homestead or 545,000
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 foe manufactured home that is not assessed as reel property may
not exceed one-half(12)of the assessed value of the mobile home or manufactured home.
Signatre of And:or Date signed(month,day,year)
DISTRIBUTION: Orgnal-County Auddoe,FleSamped Copy-Taxpayer