No preview available
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