HomeMy WebLinkAboutHomestead_Klusmeier CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
'' i STANDARD/SUPPLEMENTAL DEDUCTION FORM
State Form 5473(R1515-14) HC10
Prescribed by the Department of Local Gwem-.era Finance
INSTRUCTIONS:See reverse side for filing instructions.
NOTE:Telephone,Social Security,driver's license,state identification and federal identification numbers are confidential under IC 6-1.1-f- -
A fl c.:i CERTIFlCATON STATEMENT _', -,.-. - ,,r:i,• .
I(We) / -'-fl a.i - A,rn' certify that l(we)occupied as my('1 e( ci•.I !1
place of residence or (are)buying the following described rf property under contract for which a Homestead Property Tax Stan•a•'
D uclion is hereby •( ed on the date this application is signed, (date o/signature).A,{�p):-
n. ❑ Am(are)buying under recorded contract. J/il� 3 0 2,15
ID Am (are) entitled to occupy as a tenant-stockholder of a cooperative housing corporation. J
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified,ttersona i!'.-nce t,st
❑ Am (are)the shareholder, partner, or member of the entity that owns the property. 1-1/880N VA- ?[y��.
•
It buying on cr.5act Fee Simple owner's name
Reader's c°s¢where entree is recorded Record numbs 1 Page
?1_11_.._, iGv-4t,-.-_) s .L.e* i.t-�_, :-: --s.*PROPERTY DESCRIPTION. _r .--_ ' _ '7•� r—r
Township Taxing of ,:oon,fawn '•)
/JI w / / L..11—t_.4, ,'
Parcel number Legal•oi.ption Is -property es:o: f
I.: 41? / - ;
❑ . 40 assess d mobie home(IC 6-1.1-I)
If a ••..ion of the residential soctate or the land not exceeding one(1)ace that nomad elyys�surr7rro�undss j2taatt tnu GUre is used to produce income,des-be the use and paean
of .perry utxed to produce trmne. • e�'1/ q
A-/7//-o2U0-O0/ 7/4 -Oa/
Six.County.and Tovmsivp Is claimant vacating a homestead?
ID Yes ❑ No
Signature of claimant avna
I hereby certify the above statements are true,correct,and complete.
Address of mead(flambee and greet cram state,and ZIP code) Address of of v�ead.d any(number and tate,and ZIPcode)
/� �.7s9s Li 5So r o✓e�re llely- Y7nL5�
ASSESSOR USE ONLY ASSESSED VALUE I HOMESTEAD VALUE I NON-RESIDENTIAL
VALUE
Land not exceeding one(1)acre immediately (1)
surrounding residential improvement,
Other land (2)
Total land(line I plus line 2) (3)
Residential improvements or Dwelling (4)
Annually Assessed Mobile I
Manufactured Home Garage (5)
Other improvements I(6)
Total improvement,(line 4 through line 6) (7)
Total value (line 3 plus line 7) 1(8)
I hereby certify the above is true,correct, I Signature of Assessor Date signed(path,day,year)
and complete.
Veining action-Sgnacire of Auditor Date sired(month.day.year)
L t1 S . -_ - 2;_=-�STANDARODEDUCTION ALLOWANC&`r _;.:;., --r. "y
20 pay 20 Lesser of 60%of the assessed value of the homestead or 545000
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 properly or to a manufactured hone that is not assessed as real property may
not excess)one-half(1f2)of the assessed value of the mobile home or manufactured home.
Sgru^ae ofAuddo ors sgned(marxh,day.Year)
DISTRIBUTION:Original-County Aud,o,.FieSamped Coq-Taxpayer