HomeMy WebLinkAboutHomestead_Zerr CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
: : STANDARD/SUPPLEMENTAL DEDUCTION
State Fonn 5473(R15/5-14) LY ENTER',�TJiT•frel@♦
%� Presrnbed by the Department of Lost Gaaermnent Faience ' f1TION
INSTRUCTIONS:See reverse side for filing instructions. SU bject to flnal acceptance for transfer
NOTE:Telephone.Sofia/Security,driver's license,state identification and federal identification numbers are confiden ial under n::. (3112-37.
� �- �� - CERTIFICATION STATEMENT- -._ '. -- ."-='..- ''— '.--
I(We) a afail . tai %Ii • - .►S a r/ certify that!( • • pied.Tn....!r •: . I I` —
place of residence or am(a e)buying - ollowi x described real property under contract for which a ••r, ri' LSi_ Siy -5 Sta rd I it !
Deduction is hereby claimed on the da - is application is signed, (date of j re I I 1 e): ;sty
❑ Own. I] Am(are)buying under recorded contract. Parcel # -
❑ Am (are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation. qq
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified personal rrsEac2trust20 5
❑ Am (are)the shareholder, partner, or member of the entity that owns the property.
cLAlMANrslNFORMATloN ._ 2'
Recorder's office where contrail is recorded Record number I Page
•
. L -_ -- .ems .-- .::'/;3=* - :i;Irk,iPROPERTY..DESCRIPTION----z— -��?//7.i`e - .L:`,�_w- a='r_ =.. yam
County Township I •d• .ii Zaly. ttvmsh ,-.rs'ry
Parcel number legal desorption I Is the property in quesVrc /v�,
>er Real property ❑AnnuaDy assessed=tie home(IC 61.1-7)
If any portion of the residental •vdvre or the land not e.ceedi+g one(I)arse that immediately surrounds Mat structure b used to produce frame,describe the use and porgy
Sere property utilized to produce forme.
IC,—o Air- R4i — '10 / oao .305o6
PROPERTY OWNED ELSEWHERE BY CLAIMANT
Save,Carey,and Township Is claimant vacating a homestead?
❑ Yes ❑ No
re/da' m
I hereby certify the above statements are true,correct,and complete. / 7�j/°e°
Address of anal(number and meet,ray.mate,and ZIPcode) 'II Address of vacated tvres:eaaGQ arty(number and s^eet,dry.state,end ZIPmde)
P✓(J°)C Z'> r��G4 .1---- 4 6
Land not exceeding one(1)acre immediately I(t)
surrounding residential Improvements
Other land (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 pits line 7) (a)
I hereby certify the above is true,correct, Sgraatre of asaessa Date si rwd(north,day.year)
and complete.
• • .
Ve-Wg adios-Bgnatire cf Audtor „ rs .. teed ,X.. .f Rs4
Subject firs final acceptance for transfer
.a,+t.: '?r-?> _ _ 7:'yr.STANDARD DEDUCTONALLOWANCE%x Tt "•'_ .X°gj 5��3'�a—""r i.,_4
20 pay 20 Lesser of 60%of the assessed value of the homestead or$45,000
Notwithstanding any other provision,the sum of the deductions provided in/C6-1.1-12 to a mobile home lg�� Audibr
that is not assessed as real property or to a manufactured home that is not assessed as real property may •1 1th Gibson County
' not em one-half(12)of the assessed value of the mobile home or manufactured home. /�•�
\ Parce�D ' red 1( daY mon ad
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DISTRIBUTION: Original-County Aad:(pi..Fie-Samped Copy-Taxpayer