HomeMy WebLinkAboutHomestead_Kixmiller CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
-!'. = STANDARD/SUPPLEMENTAL DEDUCTION FORM
i y Save Form 5473(R15/5-14) HOW
YPrescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for filing inswcfbns. p 1
NOTE:Telephone,Social Seventy,drivers license,state identification and federal identification numbers are confidential undo I 6-I -I-ir] I ll
I(We) ti1t7`ITII 1111._: . s . certify that I(we)oc upied ur)ppj�Ipdl
place of residence o am(are)buying the follow) •described real property under contract for which a Homestead ax 514A
Deduction is hereby claimed on the date this application is signed, (date of signature). I(We):
Own. ❑ Am(are)buying under recorded contract. / •_/ e/
Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation. Y/��r
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a quaC W Sr hCQ aftstieWpIf FOR
❑ Am(are)the shareholder, partner, or member of the entity that owns the property.
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'd taste on mMdad.Fee Senile owners name
Recorders oSce where contract is recorded Record number 1 Page
P:,....11-!.-L7:...-»� LT__:.._;.... ec�—z....`__. .PROPERTY DESCRIPTION 7.i."i-c,.x-: xci;Sa:_ ''.:z-,r<-+-,err...r.-3
Crory Township Tang district(oy,fowl,totmshi)
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Parcel number Legal description pton Is th rty N question:
A6-1a-51-c0 l-ooeal1±55 -V a% eel p ry ❑Annuaal,assessed moue home(IC 61.1-7)
If any port cn of the residential structure or the land not exceeding one(1)acre that immediately surrounds that structure is used to produce income,deambe the use end pennon
of the property utilized to produce ire.
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State,County,and Township Is claimant vacating a homestead?
❑ Yes ❑ No
.ire of vein V
I hereby certify the above statements are true,correct,and complete.
Address of coded(number and street oly,state,and ZlP code) Pear o sated homestead.it any(number and Beet city,sate,and ZIP code)
)rorr / - SPrtuz rife /1/41Y.7%76
ASSESSOR USE ONLY I ASSESSED VALUE I HOMESTEAD VALUE I NON:RESIDENTIAL
Land not exceeding one(1)acre Immediately I(1)
surrounding residential improvements .
Other land (2)
Total land(line 1 plus line 2) (3)
Residential improvements or Dwelling (4)
Annually Assessed Mobile I
Manufactured Home Garage (5) .
Other Improvements (6)
Total improvements(line 4 through line 6) (1)
Total value (line 3 plus line 7) (8)
I hereby certify the above is true,correct. Signature of Assessor Date signed(month,day,year)
and complete. •
Verifying action-Signature of Nil;too Date signed(menth,day.year)
e`—�.4!' u" -. 'T tT j=ST ANDARD-DEDUCTION ALLOWANCE'_- -�=_%4±--- : - -- _5
20 pay 20 Lesser of 60%of the assessed value of the homestead or$45,000
Nofwthstanding 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(12)of the assessed value of the mobile home or manufactured home. .
Signature of Aud or Date signed(mach,day,year)
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DISTRIBUTION: Original-County Asddor.FieSamped Copy-Taxpayer