Press Alt + R to read the document text or Alt + P to download or print.
This document contains no pages.
Homestead_Martin (7) �ag\.p`?�� CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
:.A ..Art STANDARD/SUPPLEMENTAL DEDUCTION OR
''�Sy State Forth 5473(R1515-14)
2' Prescribed by the Department of Local Government Finance .
INSTRUCTIONS:See reverse side for filing instmclions.
NOTE:Telephone,Social Security,driver's license,state identification and federal identification numbers are confidential under IC 6-I.1-12-37.
- ' T CERTIFICATION STATEMENT' - - - - -I(We) 14 /' �•. l I4 I 2? L _,a 4 -rtify that I(we)occupi a m i(o h ,o
place of re-1•ence or am(ar uying the following described real roperty under contract for which a Homestead rope j T.s Qrd I .
Deduction is hereby claim-in the date this application is signed, (date of signature. I(We): q
❑ Own. ❑ Am(are)buying under recorded contract. DEC 1-2 2O 4
❑ 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. , •.. a snT rj
fer
- - - - '.,
If buying on contract,Fee Simple owners name
Recorders o:ce where contract is recorded Record number Page
L.., _w C&s.._. -:_'- °' -s'= .PROPERTYDESCRIPNON roc ..:'Sc ,;� --'4._"kt i"=- a
Caady�^ Township Taring district(city,tow.touns2p)
Parcel number Legal deseripbon 7 7.3v Ac is the pr eny in cues=
P-r NA G- 3- // ❑Real property ❑ &sivalt assessed mode home(IC&ui-n
If any porton of the residential stucco or the land not exceeding one(I)acre that inmediatey surrounds that=iota-re is used to produce income,desaibe the use and portion
of the property utilized to produce income.
260- 10- O& - 200 - 000 • / 501 - o ../
PROPERTY OWNED ELSEWHERE BY CLAIMANT
Sap,Commit and Township Is claimant vacating a homestead?
❑ Yes ❑ No
Si nature of claimant
I hereby certify the above statements are true,correct,and complete.( nu_'a street. �'„y„ !LLa ✓' l
Address of conct(number and et.aty.sate.and ZIP code) 1~Adddresst/^l of vacated homestead.d any(number and meet,my,state,and ZIP code)
k 5'-11, w.LISO S. pu,Yruvi see .In LI7W
ASSESSOR USE ONLY ASSESSED VALUE I HOMESTEAD VALUE I NONRESIDENTIAL
VALUE
Land not exceeding one(1)acre immediately (1)
surrounding residential improvements
Other land (2)
ITotal land(line 1 plus line 2) (3)
Residential improvements or Dwelling (4)
Annually Assessed Mobile I
-
Manufactured Home Garage (5)
Other improvements (5) '
Total improvements(line 4 through line 6) (7)
Total value (line 3 pies line 7) (a)
I hereby certify the above is true,correct, I Signature of Assessor Date signed(month,day,year)
and complete.
Vedying action-Signature of ud,tor Date signed(month,day,year)
•
str -.3 ` „'-* t-a-of STANDARD DEDUCTION ALLOWANCE=-cs. a T1 ".0 c
20 pay 20 Lesser of 60%of the assessed vane 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 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(12)of the assessed value of the mobile home or manufactured home.
Signature of Aud or AA Plate signed(month,day,year)
DISTRIBUTION: Odgmal-County Author,Fie-Stamped Copy-Taxpayer