Homestead_Coomer (4) CLAIM FOR HOMESTEAD PROPERTY TAX FOR°
;' STANDARD / SUPPLEMENTAL DEDUCTION
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State Form 5473(R13/12-09) HC10
�° ,� Prescribed by the Department of Local Government Finance
/ _
I(We) ,7t i _ �'S - certify pie principal
place of residence or am(are)buying the following described real property for which a Homestead Property Tax d d duc i I -r claimed
under contract on the date this application is filed, (date of filing). I(We): •
OEOwn ❑ Am(are)buying under recorded contract SEP 2 3 2014
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 r sidence trust
❑ Am (are) the shareholder, partner or member of the entity that owns the property.
,. _ _ ._. � •. ,
If buying on contract,Fee Simple owner's name
Recorders office where contract is recorded Record number Page
,I
),P.ROPERTYiDESCRIPTION --
` _. ,
County Township .,..�r��_ _` /
Parcel number Legal description Is the property in question:
eal property ❑ Annually assessed mobime(IC 6-1.1-7)
If any portion of the residential structure or the land not exceeding one(1)acre that immediately sumoun�t structure is used to produce income,describe the use and portion
of the property utilized to produce income.
fill/
alP / 9/ / Fe -9/a / oo / 3ga - oo7
PROPERTYzOWNED.BV CLAIMANT IN OTHER:COUNTIES - - -
County Township County Township .,
I hereby certify the above statements are true,correct and complete. Signature aim /Cl� •
.dress(number and street city slate,and ZIP code)
l{� O E )r///� S ) OAkM,0) 1/✓1 4,0 -
f ASSESSOR USE,ONLY. ! TRUE ;VALUE o AAT:EWSED VALUE TT,V I HOMESTEAD VALUE.. If_o VALUE
Land not exceeding 1(one)acre immediately
surrounding residential improvements. (1)
Other land (2)
Total land(line 1 plus line 2) (3)
Dwelling (4)
•esidential improvements or Annually
• sessed Mobile/Manufactured Home Garage (5)
0 her improvements (6)
.tal improvements(line 4 through line 6) (7)
.tat value (line 3 plus line 7) (6)
Signature of Assessor Date signed(month,day,year)
ereby certify the above is true,correct,
d complete. Date signed(month,day.year)
\tying action-Signature of Auditor
v STANDARD DEDUCTION ALLOWANCE - - - - -- --
Lesser of 60%d the assessed value of the homestead or$45.000 h Ni fL c -2
p0__Pay 20 prodded in IC 6-1.142 to a mobile home Nat is $ f J°�
roviion,the sum of the deductions rnaa property may Notes. slandiri9 any other P or to a manufactured lame that IS nrlas5essed e. real ma not exceed
e or manuAalured home. ,, , •
ro. assessed as real p assessed value of the mobile hap
one-half assessed s real
assessed
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