Homestead_Pichon CLAIM FOR HOMESTEAD PROPERTY TAX I YEAR
al_.i it STANDARD I SUPPLEMENTAL DEDUCTION FORM
L. Sate Fonn 603(R15/5-14)
�, Prescribed by the Depafinent of Local Government Finance
INSTRUCTIONS:See reverse side for riling instructions.
NOTE:Telephone,Social Security,driver's license,state identification and federal identification numbers are confidential und-i r 6-1!-12!:7. i
�jpr. '-CERTIFICATIONSTATEMENT' t_., - . i s�:ns 'L
I(We) -! -.aa_AI certify that I(we)occupied as my(our)principal
place of residence or am(are)buying the following described real property under contract for which a Homestead FlOterty4ax SIM&
Deduction is hereby claimed on the date this application is signed, (date of signature). I(We):
❑ Own. ❑ Mn(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 qual ONabr ff• 9erAUD TOR •
❑ Am (are)the shareholder, partner, or member of the entity that owns the property.
- -- ___"� '.
-"
If buying on contract,Fee Simple owners name
Reorders oSe where contract is recorded Record number I Page
_-e r, t'_ -°�-_.=.:x _ ;=PROPERTY,DESCRFPTION t'Sr" __ _ -C ^. 3
County Township Taxing drs • (sty,town
Parcel number Leg description Is the property in question
/ / ❑Real property ❑Annually assessed mobile fame(IC 6-1.1-n
If any portion of the residercal structure or the and not exceeding one(1)acre that immediately surrounds that structure is used to produce income.desoi a the use and porion
at the property U,d¢ed to produce rerun.
;.. (0 . 1.0 - at -2 - / oo - coo . 3v7- oo /
PROPERTY OWNED ELSEWHERE BY CLAIMANT
Sale,Cary,and Towratilp Is claimant vacating a homestead?
I ❑ Yes ❑ No
Signature of claimant
I hereby certify the above statements are true,correct,and complete. I �L t (1
4 Address of contact(number and.&reel city,state,and ZIP code) 11,( dress of vacated homestead,d any(number and street sly,stare,and ZIP code)
X55 S. 854 C. C ¢ 3-C
Land not exceeding one(1)acre Immediately I(1)
surrounding residential Improvements
Other land (2)
-
Total land(line 1 plus line l) (3) _ --
Residential improvements or Dwelling (4)
Annually Assessed Mobile I •
Manufactured Home Garage (5) •
Other improvements (6)
Total improvements(line 4 through line 6) (7)
Total value (line 3 plus line 7) (8)
I hereby certify the above is true,correct, Signature of Assessor Date signed(month,deg year)
and complete.
Va lyi g action-Signature of Aud.tor Date signed(nod*day,yeas)
zi :� c poi&- ,X=J;f;STANDARD.DEDUCTIONALCOWANCE _—: - . . : _.rarer==-_-=1
20 pay 20 Lesser of 60%of the assessed value of the homestead or$45,000
Notvn:hsanding any other provision,the sum of the deductions provided in IC 6-1.1-12 to a mobile home S
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 ojf,Paidlor}, Date signed(month,day.yew)
o
DISTRIBUTION: Original-Coady Auditor,Fie-Stamped Copy-Taxpayer