HomeMy WebLinkAboutHomestead_Tedrow ^`"." CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
STANDARD/SUPPLEMENTAL DEDUCTION FORM State Form 5473(R15I5.14)
\%5wr/ Prescribed by the Department of Local Government Fiance
INSTRUCTIONS:See reverse side for Ong instructions-
NOTE:Telephone,Social Security,drivers license,state identification and federal identi fication numbers are confide . •e-) tit.1-12-}'. 111117
` '��' -1 rn, I, '� CEFPFICA^ON STATEMENT ]5_i. .h. - - - - •
I(We) -in.ill,an.&WI�I
certify that I •W. y( • a._.
(•:- o • pi-•as my(our)principal
place of residence or am(-r)buying the blowing described real property under contract for which a Homestead Property Tax x'AIandard
t4
Deduction is hereby claim-•on the date this application is signed, (date 40014 Iaett
0 Am(are)buying under recorded contract.
Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation.
0 Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualifi ed trust. .
0 Am(are)the shareholder, partner, or member of the entity that owns the property. GIBSON COUNTY AUDITOr
- _ _
_-.
If buying on contract.Fee Simple owner's name
'Recorder's office where contact is recorded 1 Record number I Page
_.Tstsr.1- t_c --s-' '- r_= .•Trzd pROPERTYDESCRIP-TION'+� -r-.� s. im_f.- �._ -eaS
Cou SI Township Taxing•stria( RI lounsh)))
-arced number Legal desaip oh Is the pr ry in question.
n r l /07/T T l•o/./57—o a' th✓Real propefi 0 Anna%assessed mobile home(IC 5-1.1-7)
a n n of�r the reresidential sbtc'are or the land not exsedvg one(1)acre that'u:nediately sunound's that structure is used to produce brume.denote the use and pot
of the property iLil¢ed to produce income.
PROPERTY OWNED ELSEWHERE BY CLAIMANT
stare,county,and Township Is claimant vacating a homestead?
0 Yes 0 No
Sign damam
I hereby certify the above statements are true,correct,and complete. itif-Address of auras(number and speet my state,and ZIP code) Address cetpd nor�eed,C nY(nu •; and Street,ay,state,and LP rode)
ICI r G) 4 i 0hts . tt .
ASSESSOR USE ONLY I ASSESSED VALUE I HOMESTEAD VALUE I NONREASIIDENTIAL
VE
Land not exceeding one(1)acre immediately I(1)
surrounding residential improvements
Other land (2)
Total land(line 1 plus line 2) (3)
Residential Improvements or Dwelling I(4)
Annually Assessed Mobile I
Manufactured Home Garage I(5) I
Other Improvements (6)
Total Improvements(line 4 through line 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.
Vedybg action-Signature of Aidto Date ' \\year)
:5_
• �-_ -' . •_��_."x3STANDARDOEDUCTION'ALLOWANCEy ttt?c=Alr, x S .Zy__
20 pay 20 Lesser of 60%of the assessed value of the homestead or S45,000
Notwithstanding any other provision,the sum of the deductions provided in IC 6-1.1-12 to a mobile home S MAY 2 8 2015
that is not assessed as real properly or to a manufactured hone that is not assessed as real property may
not exceed ne-half(12)of the assessed value of the mobile home or manufactured home.
Santee of a
r'e signed
.f. e I
DISTRBUTION: Ongpal-COmy Audto,FieSamped Copy-Taxpayer c (t5s0 11—Or. ITOR