Homestead_Reel _ 1 ,
t'.:,, CLAIM FOR HOMESTEAD PROPERTY TAX ' OI r -
STANDARD/SUPPLEMENTAL DEDUCTION 31 I
tie State Form 5473(R13112-09) HC10
Prescribed by the Department of Local Government Finance , 1 201'
INSTRUCTIONS:See reverse side for filing instructions. 1
rxr SR`s b' 'S2 `ice - 5 TF -'L..-: IZ�y ri (sn afi' Y'r' ' 2- it
l35h,j +.3t�i`,��,.��;'`y� +— �' CERTIF;/)CATI�O :S/TAIEMEtnT��� ;y; "7t lv(i,:` etf.�Ye,a� s-� �'�.:t-F
I(yye) eLi�/ ��—.��/Jf'gf/ AL�1•i71' certify 0113SONDOCIAttliSfMillOSIFISanipal
place of residY or am(are)buying the following des.A /.?
- prop/ for which a Homestead Property Tax Standard Deduction is hereby claimed
under contract on the date this application is filed, (date or filing). I(We):
Own ❑ Am(are)buying under recorded contract
❑ 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 residence trust
❑ Am(are)the shareholder, partner or member of the entity that owns the property.
....tai i - ter- s i'$:2 ,i,l _. ;` t v.?s r
u*"xat
If buying on contract,Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
;f .cr:r a ec - `(.a"' `Ee t" PR0 PERTY'DESCRIPaTI0 x,' _.''zd- d-ia.= g:. t !, a'1+•'f'.1`tr.AM
Cou Di / Township Ta> ( ,town,ttoo'wmnsshhi'py,))
Parcel number Legal desaiption I I in OUes�n:
reedy ❑ Annually assessed mobile tome(IC 6-L I-7)
FMS°•' x'yt"",7 2'14V4(, - ;j:¢;ys' 'reMROPEIT OWNEDjBYj,C7AIfIfire T IN C H .COUNTIES` , ?, .n''`f.,l 1(ki 'grililf:CM it 3'
County Township
I hereby certify the above statements are true,correct and complete A. i. •. - • /
_ 7 7 70
-y i".� '"t`!�"-""=��, ' 1r, 2 j 1 ¢ � TA SSESSED VALUEN'HOMESTEADtsr`' ? NONRESIDENTIAL/°-.=-''-h
A ,`>aAS ESSS,OR 11SE,ONLY t "yrE TRUE�TAY VALl1E AT1100%1OFaTiTV seekVALUE.�' 'Lk tRt'ZVAL•U E Fi, a-
Land not exceeding 1(one)acre Immediately
surrounding residential Improvements. (1)
Other land (2) .+.i
Total land(line 1 plus line 2) (3)
Dwelling (4) i:...'�v. S^a.'ris - Ft_
Residential Improvements or Annually
Assessed Mobile I Manufactured Home Garage (5) l..r'-, -+ _.,r.
Other Improvements (6) - �`
Total improvements(line 4 through line 6) (7)
Total value pine 3 plus line)) (6)
I hereby certify the above is true,correct, Signature of Assessor Date signed(month,day.year)
and complete.
Verifying action-Signature of Auditor Date signed(month,day,year)
l',.--`ire` ax `ar:i.: 31..".aa? *;-rn'ft' - .-`. aSTANDARD DEDUCTIDTIWt OWANCE .' agga '„rtiVa'eS:!1";Z:A. `' i*_7._:ar-g
20 pay 20 Lesser of 60%of the assessed value of the homestead or$45,000
Notwithstanding 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(1,2)of the assessed value of the mobile home or manufactured home.
Signature of Auditor Date signed(month,day,year)
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