HomeMy WebLinkAboutHomestead_Stephens (4) 1^ CLAIM FOR HOMESTEAD PROPERTY TAX FORM - YEAR
e_-�i % STANDARD I SUPPLEMENTAL DEDUCTION HC70
Sate Forn 5473(R151 5-14)
� Jl Prescribed by the Deparanent of Local Government Pounce
INSTRUCTIONS:See reverse side for filing instructions. I
NOTE:Telephone,Social Security,drivers license,state identification and federal identification numbers are confidential under IC 1-12- I r.
'' - "7' n CERTIFICATION STATEMENT-3 `1:— . ==1 r'
I(We) /!Ira: s� - - • ' certify that I(we)occupied agirjr.pur)principal 4
place of residence or am(are)buying the following described real property under contract for which a Homestead Prop&aiStan
Deduction is hereby claimed on the date this application is signed, (date of signature). I(We): �j
/`''ten. ❑ Am(are)buying under recorded contract.
IJ Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation. 0/880N((�� •
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified per on2QU . •
❑ Am(are)the shareholder, partner, or member of the entity that owns the property. / r AUQ� OR
):
If buying on contract,Fee Simple owner's rams
Reorders oSce where contract is recorded I Record number I Page
E, `^- ),/'- '° -s r:. t._ -. r I.PROP ERTV.DESCR1PP.ONIG:, ..I'M `" F - - •sw.._r
County - To nstvp Tai • -the relyy town loxns.))y//-j//�
Q f Owl 41/15-
Parml number Legal/�saip•= / ! I is the ropeM m question:
�) a -J nl /'. y /I Real property ❑Annually assessed ate come(IC 6-1.1-7)
■
II any $' of the residential stuC re or the land not exceeding g one(1)aces that immediate. un7 that structure is used to produce aeon,describe the use and piston
of the..opedy vilaed to product imre. 1 r
07� —/�—o 2 jo i443. 6196-6c2 2
PROPERTY OWNED ELSEWHERE BY CLAIMANT
I Sax,County and Township Is claimant vacating a homestead?
Yes ❑ No
I hereby certify the above statements are true,correct,and complete. /
/�
Andress of contact(number and treat Cy a and ZIP coda) t'ress of vacated ha:eveed,d any(number end street ray sate.end ZIP code)
// ,1 I /� L/ r L • - r �re �_ l �r . I
((��(l,�/ ASSESSOR USE ONLY I ASSESSED VALUE I HOMESTEAD VALUE I NON-RESISIDENTIAL
VUE
Land not exceeding one(1)acre immediately I(1)
surrounding residential improvements
Omer land 1(2)
Total land(line 1 plus line 2) I(3)
Residential improvements or Dwelling I(4)
Annually Assessed Mobile/
Manufactured Home Garage (5)
Other improvements (6)
Total improvements(line 4 through line 6) (7)
Total value (line 2 p/ls line 7) (a)
I hereby certify the above Is true,correct. Signature of Assessor Dare signed(monan,clay,yeas)
and complete.
Ven0ing action-Signature of Ad::or Date signed(moth,day yeah
_ii ."$ $---. .-- .t,.= .2_STANDARD DEDUCTION ALLOWANCE-`?L, . {.i i.. .' di.d't•.1`
20 pay 20 Lesser of 60%of the assessed value of the homestead or$45,000
Notvalhslanding any other provision,the sum of the deductions provided in IC 6-1.7-12 to a mobile home 5
that is not assessed as real property or toe manufactured home that is not assessed as real properly may
not exceed one-half(1R)of the assessed value of the mobile home or manufactured home.
I Signature of Ndtar Date signed(nana day year)
DISTRIBUTION:Ongthal-County At dden FaeSamped Copy-Taxpayer