HomeMy WebLinkAboutHomestead_Mitchell (10) CLAIM FOR HOMESTEAD PROPERTY TAX I YEAR
:e_n STANDARD I SUPPLEMENTAL DEDUCTION FORM
.lQgd Sate Form 5473(R151S14) HC10
. s� prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for filing instructions.
NOTE:Telephone,Social Security,driver's license,state identification and federal identification numbers are confidential under IC 6-1,1-12-3L
` CERTIFICATION STATEMENT- - ' * , 1.h?",Jr JJ
I(we (r � [ a
// certify that I(we)occupied as my(our)• 'WI L
place of residence or am(1,buying the following described real property under contract for which a Homestead Property Tax Standard ��
Deduction is hereby claim=•on the date this application is signed, (date of signature). 11V/7�n L ) p "��//
❑ Own. ❑ Am(are)buying under recorded contract. ����If i O ?Q/S
❑ Arn (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 p$'y aaire i, trust,
❑ Am(are)the shareholder, partner, or member of the entity that owns the property. °130/(1 c, ems' /
>, " ' -
If bu'Prg on contract Fee Simple owners name
Recorders oSce where contract is recorded Record number I Page
County Township I Taxing ' Cory town,wiseacre)
/( fr/� t
Parcel number Legal 'peon I is the pr pent'in ques.rm:
- J 7!' CG //2/) Real properly ❑ Annually assessed motile tame(IC 6-1.1-7)
If any portion of the residemial structure or the and not exceedig one((11)aae Othatt�ynediateely that due is used to produce income,desaibe the use and ponce
of the property td¢ed to produce income.
014/02-/Z doe-oa/. Lie-oat
PROPERTY OWNED ELSEWHERE BY CLAIMANT
Sala,Canty,and Township Is claimant vacating a homestead?
D Yes 0 No
Signature of clamant ..,�� ,/ /
I hereby certify the above statements are true,correct,and complete. �L^•�L�`�
Address of contact(number and street oY.state,and ZIP cede) Address of vacated N-r eY•ead.6 any(number and greet C/,&are,and ZIP cock)
�C /033 S S. SToq TsT/%r;,G�d,, L/147E7 1
ASSESSOR USE ONLY ASSESSED VALUE I HOMESTEAD VALUE I NON-RESIDENTIAL
VALUE
Land not exceeding one(1)acre immediately (1)
surrounding residential improvements
Other land (2)
Total land(line 1 plus line 2) (3)
Residential Improvements or Dwelling (4)
Annually Assessed Mobile I
Manufactured Home Garage (5) -
Other improvements (6)
Total Improvements(line 0 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,day,year)
and complete.
Vedyirg adbn-Signature of Auditor ' Date signed(month day,year)
3-1:-2.f-n:777.2 P, $: . -pi+ - •3fl STANDARD.DEDUCTIONALI.OWANCE''.-e7 =5?_ W ,.z` . "_ Z
20 pay 20 Lesser of 60%of the assessed value of the homestead or 545,000 �,
Notwithstanding any other provision,the sum of the deductions provided in IC 6-1.1-1210 a mobile home $
that is not assessed as real properly or to a manufactured home that is not assessed as real property may
not exceed one-hal(12)of the assessed value of the mobile home or manufactured home.
Signature at Auditor Date signed(pat%day,year)
DISTRIBUTION: Ongi al-Ctrey Addha.File-Stamped Copy-Taxpayer