Homestead_McKay rftCLAIM FOR HOMESTEAD PROPERTY TAX YEAR
STANDARD!SUPPLEMENTAL DEDUCTION FORM
State Form 5473(R1515-14) HC-I0
' Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for filing instructions.
NOTE:Telephone,Social Secunty,drivers license,slate identification and federal identification numbers am confidential under IC 6.1.1-12-37.
I(We) certify that I(we)occupied as my(our)principal
place of r idence or am(are)buying the following describ real prop under contract for which a Homestead Property Tax Standard
Deduction is hereby claimed on the date this application is signed, (date of signature). I(We):
J 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.
_ _ -.:•:-..,:.^
If on coat t Fee Simple owners name •
L9 czyt ,CULL etap9 Ad extei ,
R a°Zoe where conga=is recorded 'Record number Page
g2-14.. _ hi ".,PROPERTY.DESCRIPTION 1r r t t _ ou --- rfy I4se'--"a•
County Township
Taxing disaid(city fon*41oenNP)
P 'lal number �/�/ [�]�/Leeggal desaiaion Is the property in queston:
V -04- 4'300 -Got • I y 6 ❑Real property ❑Amua%assessed mobile home(Sc 6-1.1-I)
any portion of the residential structure or the land not esceedbg one(t)acre that immediately surrounds that shucture is used to produce income.describe the use and portion
of the property utted to produce home.
��'(aaJuua l at�,�. g
Sate,Canty.and Township Is claimant vacating a homestead?
❑ Yes ❑ No
h Signature of damam
I hereby certify the above statements are true,correct,and complete. %%7 Aced. of coritaa(number and street.cry.ante,and ZIP code) dress of vacated no. .ead,d any(numbereT Sneer,cry,rate,an
- O5 S O . S 1
ASSESSOR USE ONLY I ASSESSED VALUE I HOMESTEAD VALUE I NONR/ESISIDENTIAL
UE
Land not exceeding one(1)acre Immediately
surroundin•residential im•rovements (I)
Other land 1(2)
Total land(line I plus line 2) (3)
Residential Improvements or Dwelling (4) i, i l,.1
Annually Assessed Mobile I
Manufactured Home Garage I(5) 1 ��.:�i�',�
Other Improvements (6)
Total Improvements Nine 0 through line 6) (7) 1• e
Total value (line 3 plus line 7) (8)
I hereby certify the above is true,correct,
Signature of Assessor •gga� f r�ty'�
and complete. aTP��e��•r
Ve yig action-Sgnatrecf Arbor It • - 0 ._ -,srer. a.1P!D • -
_-J'r-- ,e try . STANDARD DEDUCTION ALLOWANCEFr - . .0•^_011.7.2 __- --7 2w= -°v'17 •
20 pay 20 Lesser of 60%of the assessed voue of the homestead or 545,000
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 properly or to a manufactured home that is not assessed as real properly may
not exceed on -half(1111-2)of the assessed value 9' s e mobile home or manufactured home.
sgYa
nre of Audit Date agrcd(47 daY. e
•
DISTRIBUTION: Original-Gamy Auditor,File-Samped Copy-Taxpayer