Homestead_Schwartz CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
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:Ai STANDARD/SUPPLEMENTAL DEDUCTION FORM
S State Form 5473(R15/5-14) nm HO10
Prescribed by the Department of local Government Fiance
INSTRUCTIONS:See reverse side for filing instructions. i I,) '
NOTE:Telephone,Social Security,driver's license,state identification and federal identification numbers are con, ential de C : 2-
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I(We) Al ad_ s([ • i Cl" , fl !l L _ s! i •ify that I(wrpi¢ •lp9d as cur)principal
place of residence am(are)buying the foil. •described real property under condi for which a Homes ea PropfeW tax Standard
Deduction is hereby claimed on the date this application is signed. (date of signature).�I�(We):
rOwn. ❑ Am(are)buying under recorded contract. mL };-¢y
❑ Am (are) entitled to occupy as a tenant-stockholder of a cooperative housing corporaf)raySON.�''u NLTNyiGLAA�
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms o a qua ci perso
❑ Am (are)the shareholder, partner, or member of the entity that owns the property.
If buying on conbact,Fee Simple owners name
Recorders office where contract is recorded Record number 1 Page
at-442 PROPERTY DESCRIPTION,.T_2.—ii7 - ' Li
County Township I Ta' distn (cdx tm-f,township)
Parcel number Legal description Is the properly in question:
PReal property ❑ Annually assessed mobie home(IC 6-1.1-7)
a any'croon of the residential stuMse or the lard not exceeding one(I)acre 8158' 00 surrounds that structure n used to produce income,describe the use and portion
of the,"+w�•y nttized to produce income. t 815 9
2&—/90/—,S'c3 err 00
PROPERTY OWNED ELSEWHERE BY CLAIMANT
Sate,County,and Township Is claimant vacating a homestead?
❑ Yes"vi No
'true,correct,and complete. /
tot claimant S / ..I hereby certify the above statements are
Address of oamaa end(nun r e street,coy state,and ZIP code) .:;. qi
w. �/Q °V S ae _ .ya Al
ASSESSOR USE ONLY ASSESSED VALUE I HOMESTEAD VALUE I NON-RESIDENTIAL
VALUE
Land not exceeding one(1)acre immediately (t)
surrounding residential improvements
Other land (2)
Total land(line 1 plus line 2) (3)
Residential improvements or Dwelling (a)
Annually Assessed Mobile I
Manufactured Home Garage (5)
Other improvements (6)
Total improvements(line 4 through line 6) (7)
Total value (line 3 phis line 7) I(6)
I hereby certify the above is true,correct, Signature of Assessor Date signed(nveh,day.Teal
and complete. .a
Vedyvg arum-Sgnature of Poo:= ) r .tesg :I(IInmi ay. del
I •
=:y - y` =STANDARD,DEDUCTIONALLOWANCEF-,�-._ +...,_ q ,=.-
20 pay 20 Lesser of 60%of the assessed value of the homestead or$45,000 APR 2 2015
Noasethstanding 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 property or to a manufactured home that is not assessed as real property may
not exceed one-half(1/i)of the assessed value of the mobile home or manufactured Mme. j
Sgv Cr ril.2,T.TE:.Teal
c Vl " �„yc GIBSO�J ~l A1,54
DISTRIBUTION:Onginal.County Ad,-,or.Fie-Stamped Copy-Taxpayer