Homestead_Hartley (2)CLAIM FOR HOMESTEAD PROPERTY TAX
STANDARD / SUPPLEMENTAL DEDUCTION
State Form 5473 (R13112-09)
Prescribed by the Department of Local Gmemment Finance
INSTRUCTIONS., See reverse side for filing instructions.
FORM YEAR
HC10
__ T If ; IF,I _.
E R
,:i.?[1i:'.`�.�- 5�z1�� ♦`:• r�„�T_} ��.rtar��l;w».3�i3%3 CICATION'STATEMENT��:..`:�"� "-E�9.'�n�.'"C'8r .r:i .._�F•_.•s Txa�'v>'s-�•• ?ti: y` a %t `�3,��:>.��.
� =
place of rps r:
. ..
AUDITOR
Have a beneficial interest in the trust or the right to c,cctipy the property under the terms of a qualified personal residence trust
Am (are) the shareholder, partner or member of the entity that owns the property.
+°?f L.. `� �" >'?tf.. lc'��'. ¢ s�,.,; �«'• 0��;. tiitF' T.. �`.CLAIMANT.Si1tJFORMATION,".Y, � 4 ' f'�`.,y '" 3��- `: +�,r � s . ��.f �L -
i1:-. .v.,�.3.t .�.._�r_ :cd...V .;_,it .J'.A]'.' -•5 ➢i
it (last live digits)
D Odwmmber
of claimants spouse (last Ove digits)
If buying on comnact. Fee Simpla owrtees name
"�..1:�,u'�a$s �':5.:�- :�r„v- �taY•r•c:` 3��tY�S��
-`8:3.:�i'4�.itA�PROPERT.Y DESCRIPTION:.:f $ a%Sfl _+1S.�i- ..`l��.S"f...�s•.�`<ti; sT�.,�_. "?vs
_':i.:b.wt �.
W�rf�.���
• Is the property
I / / /- • �P.1 Mperty . A.Ualty ,..it moblf.
OW
I
PROPERTY OWNED BY; CLs AIMA�T: INOTHERiCOUNTIES `4?yy�{,�'.`js,,.�
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ASSESSED VALUE'll
'aHOINESTEAD�
`�:�pNON RESIDENTIAL � -`�f
ASSESSOR USE ONLY r¢ I.TRUE
_AT_700�_.
.;&VAE k
Ana .. �.VAL'UE. s•tsi
20 pay 20 Lesser of 61'. of 111
Notwifttaniffrili anyotherprovrsion, the sum offhe deductions provided in IC 6.1.1-12 to a mobAe home Uwt is
not assessed as real priper?), or to a manufactured home that m not assessed as real property my not exceed
oiie-W (1/2) of the assessed vahm of the mobile tozna or maruditafurad home.