HomeMy WebLinkAboutHomestead_Reinhart nF CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
:4-- %% STANDARD I SUPPLEMENTAL DEDUCTION FORM
State Form 13(R1515-14) HC10 f 111.
Jrm Pretoibed by the Department of Local Government Finance : I 1
f )
INSTRUCTIONS:See reverse side far firing instructions. j 1-
NOTE:Telephone,Social Security,drivers license,state identification and Wei&identification numbers are confidential under IC 6-1.1-12-3
. �� CERTIFICATIONSTAIEMMENT,_. - _ rT.'_ �1y
I(We) ��� �`eP .� .' WA/-"aC certify that I(we)occupied as m mFdd1){eidpa l�C
place of••- •-nce or am(are)buying e following described real property under contract for which a Homestead Property Tax Stands J
Dedu hereby claimed on the date this application is signed, (date of signature/ (We):
i
N
laYn. ❑ Am(are)buying under recorded contract. CMSO i"r��
❑ Am (are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation. COUNTY A
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified personal residence trust. O)TOR
❑ Am(are)the shareholder, partner, or member of the entity that owns the property.
Recorders office where muse is recorded 1 Record number 1 Page
3 i"I' _v'rt -- _ <a . PROPE RTY.D.E_SCRIP-TION_fi>x s y _ ,�;�=..3ta;om 1: —e??a 3
Parcel umber Legal description f Is the pre -f n
y in questio
L - -,/ - - /, - ,o- . / - -- , - 1 -eal property ❑ Amuaty assessed mole home(IC 6-1.14)
If any ea of the residential s:.-nnure or the land not exceeding one(I)acre that immediately surtou .5 that=duns is used to produce''mco.^e,describe the use and portion
of the oropeny td¢ed to produce income.
PROPERTY OWNED ELSEWHERE BY CLAIMANT
Ste,County,and Township Is claimant vacating a homestead?
❑ Yes ❑ No
Sgna imam
I hereby certify th�bo a statements are true,correct,and complete_xylj��,,�Jre r ' /
^ Amus11-11lnmroai-tii-r.otr.rave ar11 ✓I\ow T' uilsiocti- 1,1rores:ead.aarry(number arc rreet ly.raze.aw ZlPrme),
' `LJ" X y11-11 3 ;t'lu N ,lN-X"y1
Land not exceeding one(1)acre immediately I(1) I
surrounding residential improvements
Other land I(2)
Total land(line 1 plus line 2) 1(3) I
Residential Improvements or Dwelling I(4)
Annually Assessed Mobile I
Manufactured Home Garage I(5)
Other improvements (6)
Total improvements(line 4 through line 6) (7)
Total value (line 3 Alms line T) (8)
I hereby certify the above is true,correct, Sgramre of Assessor Dare signed(month,day yea0
and complete.
veu,we action-Signature of Aud::or Date signed(month,day,year)
- t = —„ - -'-%STANDARDDEDUCTIONALLOWANCE -E°' , °�--C4 W.
20 pay 20 Lesser of 60%of the assessed value of the homestead or$45,000
Nohtithstanding any other provision,the sum of the deductions provided in IC 6-1.1-12 toe mobile home $
that is not assessed as real property or to a manufactured home that is not assessed as mat properly may
not exceed one-half(12)of the assessed value of the mobile home or manufactured home.
Signature ofPraetor Date signed(nmm,day.year)
DISTRIauTION: Original-County Audtot,FeeSamped Copy-Taxpayer