HomeMy WebLinkAboutHomestead_West CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
trita t STANDARD/SUPPLEMENTAL DEDUCTION FORM
State Form 5473(R1515-14) HC10
Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for filing instructions.
NOTE:Telephone,Social Seventy,driver's license,state identification and federal identification numbers are confidential under IC 6-1.1-12-'7.
/r/L certify that I(we)occupied as.•C (• r)?-ny..l
place of residence or am are)buying the following described real property under contract for which a Homestead Property T- _t. -II-ard '
Deduction is hereby claimed on the date this application is signed, (date of signature). I(We):
riSL,Cenve. ❑ Am(are)buying under recorded contract. APR
❑ Am (are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation. O
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified personal r -.ence trust.2 OJ 5
❑ Am (are)the shareholder, partner, or member of the entity that owns the property. o/ I, '
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.
If buying on contact.Fee Sumps owner's name
Reaxdets oIce where corsaa is recorded I Record number Page
kL 2<'i�-;n r_ y'F 3-w4- PROPERTY,DESCRIPTIONCS?'_:7 = -1-Xi i ..�- -r.. ,.yu-_.3.-
County / _ _ -_ Pict(n ,tow,township)
e
/ t t.■ t i� - .S_
Parcel nu bee yn .�'4/ Legal description isdue/p�perrymguestion
(p'� jJ' ! V/-DOO. MI_ 007 I er'Real IxopeM ❑Ar' -•noble some(IC 61.r-T)
If any;anon of the residential su re or the land not exceeding one(1)we that immediately ayvwupmrtrt��tld"IW(44 nndds that s'.rucure is used to produ•-income,desmbe the use and portion
of the property utilized to produce income.
PROPERTY OWNED ELSEWHERE BY CLAIMANT
Sate,County,and Township Is claimant vacating a homestead?
❑ Yes ❑ No
I Sign 1 claims. / rf
I hereby certify the above statements are true,correct,and complete. i r,/.vlyn`�//IJ,}---
I Address of oNar3(number and street, Rate.and ZIP code) i'•• -%�ara:- d,I a 0%Sate,and ZIP ���
'Y2 p • ' a
ASSESSOR USE ONLY I ASSESSED VALUE I HOMESTEAD VALUE I NONRESISIDENTIAL
VUE
Land not exceeding one(1)acre immediately I(1)
surrounding residential Improvements
Other land 1(2)
Total land(line I plus tine 2) I(3)
Residential improvements or Dwelling (4)
Annually Assessed Mobile/
Manufactured Home Garage (5)
Other improvements I(6)
Total improvements(line 4 through line 6) I(7)
Total value (line 3 plus line 7) (8)
I hereby certify the above is true,correct, Signature of Assessor I Dos signed(month,day.year)
and complete.
Verifying action-Sgnatae of Aadtor Date Signed(rani&day,year)
%.777-y:.:- r :"...74;m7:27-'2:2.7,. ..G' STANDARDDET!UCTION ALLOWANCEI0 :_ . .— - .;.3y .' a :1xxcer y-
20 pay 20 Lesser of 60%of the assessed value of the homestead or 545,000
Nolwtlhstanding 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 Auditor Date signed(=GM,day,year)
DISTRIBUTION: Ongial-County Aud:or,FieSamped Copy-Taxpayer