Homestead_Lofton (2) ;l-iftCLAIM FOR HOMESTEAD PROPERTY TAX - YEAR
: STANDARD/SUPPLEMENTAL DEDUCTION FORM
State Form 5473(R1515-14) HC10
J Prescribed by the Department of Local GovenuMnt Finance
INSTRUCTIONS:See reverse side for Tiling instructions.
NOTE:Telephone,Social Security,driver's license,slate identification and federal identification numbers am confidential under IC 6-1.1-12-37.
I(We) 0 certify that I(we) I
place of residence or am(are)buying t following described real property under contract for which a Horn ad ro rty Ta nd-
Deduction is hereby claimed on the date this application is signed.
�rflr Y PP 9 (dot o7 s" t Y ):I ;�•�
Own. ❑ Am(are)buying under recorded contract.
❑ Am (are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation. MAY 1 1 201,5
i
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified personal r ence t st.
❑ Am (are)the shareholder, partner, or member of the entity that owns the property.
•
If buying on con:ras,Fee Simple owner's name
Rearde's ot5re where contract is recorded Record number 1 Page
'1447 - _ -r''' - `c 4PROPERTY.DESCRIPTION:-.,.-. r c^3.' s4S51.7— _ .'x ;--`-7ai✓-zS`t
cou _ r• • 5b•(aty.t. n. wnship) �.
a r 1 / •
� / Is the property in queswi f
J gu S •f/ 4.. =Realproperty ❑Annually assessed motile home(/C 6-L1-7)
L•any pow of the Presidential-� p a.
e444 re or the land no exceeding one(1)acre that yr edely surmuM is that SruCure used to produce income,describe the use and portico
o% /O-p/— o° - lO / do -Do? 7
PROPERTY OWNED ELSEWHERE BY CLAIMANT
Sate,Carty,and Township Is claimant vacating a homestead?
0 Yes 0 No
Signets f claimant
I hereby certify the above statements are true,correct,and complete. F
Address of contact(number and street,oiy Sat)d ZIP_... ress of va/ Iwr:nest�.daM(number and street,r4Y.Sae.and ZIP ink)
\)Q:a...
ASSESSOR USE ONLY I ASSESSED VALUE I HOMESTEAD VALUE I NON-RESIDENTIAL
Land not exceeding one(1)acre immediately
surmundinq residential improvements I(I)
Other land (2)
Total land(line 1 plus line 2) I(3)
Residential improvements or Dwelling I(4)
Annually Assessed Mobile I
Manufactured Home Garage I(5)
Other improvements (6) -
Total improvements(line 4 through One 6) (7)
Total value (line 3 plus line 7) (6)
I hereby certify the above is true,correct, Signature of Assessor Date signed(month,day,year)
and complete.
1 Vayig action-Signature of Acidtor / Date signed(nrpm'h.day,year)
, _ _ L __:/r--. _?: . _ ..-;:^�-�STANDARD DEDUCTION ALLOWANCE ,' {. _v fx,,s = —ale•
20 pay 20 Lesser of 60%of the assessed value of the homestead or$45,000
Notwithstanding 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(1h,)of the assessed value of the mobile home w-manufactured home.
Sgnaure of Audror Date signed(rsn;h.day.year)
DISTRIBUTION: Orgiul-County Aud.mr,FieSamped Copy-Taxpayer