Homestead_Hull (3) — —
"-■ CLAIM FOR HOMESTEAD PROPERTY TAX
Fb I STANDARD/SUPPLEMENTAL DEDUCTION
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FORM
HC10 1 YEAR
V,!....S„... i... .; Sptaretoorie Fffedormbthne(GeRloo5/furt5-1e4n)t of Local Government Finance
INSTRUCTIONS:See reverse side for filing instructions
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NOTE:Telephone -;•al Secunty,driver's license,state identification and federal identification numbers are.j_.en 5•1 u f.er IC ai.1 2-at
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I(We) . 7.71 I i-014 nt.—1 I PROVE MIA,
certify that I(we)occupied as my(our)principal
place of resi•ence or am(are)buying th t following descsibed rea •roperty under contract for which a-twi epiepfl Tax Standard
Deduction is hereby claimed on the date this application is signed, I 1011-to(OlVigbir I(We):
1:1 Own. 0 Am(are)buying under recorded contract.
El Am (are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation. i, , ..w .,7,.,,'
El Have a beneficial interest in the trust or the right to occupy the property under theqrstro. • 101 Is =II"ff,16.-• residence trust.
0 Am (are)the shareholder, partner, or member of the entity that owns the property. 0 LI TV AUDITOR
If trying on=tract,Fee Simple owners name
. 1
Recorder's office where contract is recorded Record number Page
.1---.---02.);7.:;:t1451,1--i--2"--;r----.-a-:-..Z.....fk.;.--.-■:-MaL.4 PROPERTY.DESCRIPTION it.'.7-.fl--...--4-4.24;W:L.-TC‘..))224-8. ,4";22.--, TZL.T.c2i
• i r / Township 1 Taxing d 'Al ton - e)
mill
A ' fk 0 e_cc- O ,
Parcel number Legal desaipaon Is the property in<Pesten:
a6734- 1/44-3oaoo.a,,t!-1 .1: 2-0 . Real property 0 Annually assessed made home(IC 6-1.1-7)
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If any porton of the residential=Cure or the land not exceedmosne(I)ass hat ir2unediately surrou that structure is used to produce income.ciestalbe the use and petit
of the property utilized to produce incomeotto_1.4a0_..vr coas-ato
PROPERTY OWNED ELSEWHERE BY CLAIMANT
suite.county,and Tovmship Is claimant vacating a homestead?
0 Yes 0 No
Signature of claima
I hereby certify the above statements are true,correct,and complete.
it2 k(7/
Address of contact(number and=met,oty,state,and ZIP code) Address of vacated homestead,it any(number and street=iv rate,and 21Poode)
:Ail
ASSESSOR USE OMLY
I ASSESSED VALUE
I HOMESTEAD VALUE
I NON-RESIDENTIAL
VALUE
Land not exceeding one(1)acre immediately
surrounding residential Improvements 10) 1
Other land 1(2)
Total land(line 1 plus line 2) I(3) 1
Residential improvements or Dwelling (4)
Annually Assessed Mobile I
Manufactured Home Garage I(s)
Other improvements (6)
Total improvements(line 4 through line 6) (7)
Total value (line 3 phs line 7) (0)
Signature or Assessor Date start
I hereby certify the above is true,correct,
and complete.
Ventying action-Signature of Author Date siLe'd(mit; E D
DEDUCTION ALLOWANCE...7::-.4-4-73/47 .-nr, nni4-ree
20 pay 20 Lesser of 60%of the assessed value of the homestead or 545,000
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 r • IS TIP
not e••••••one-half(112)of the assessed value of the mobile home or manufactured home. : • • _ • I.
Date bnedjmonth,day,yea- ' • II ITOR
EMPIXda iiillin---- al_ao-i S
DISTRIBUTION: Onynal- • Astor,Fit-Stamped Copy-Taxpayer