HomeMy WebLinkAboutHomestead_Nelson (2) �' .% CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
t STANDARD/SUPPLEMENTAL DEDUCTION FORM
State Fonn 5473(R1515-14) HC10
Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for filing instructions.
NOTE:Telephone,Social Secunty,driver's license,slate identification and federal identification numbers are confident'ir•e7 C 41,.1-12-(. _
- _ - -. . • CERTIFICATION STATEMENT : - =L`-1 e•}) ?
1(We) certify that I(we)octopi-. as my .I ) -I
place of re rdence or am(are)buying the following described real property under contract for which a Homestead Property Tax Standard
Deduction is hereby claimed on the date this application is signed, (date ngure).29):
❑ 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 al quali ce trust.
❑ Am(are)the shareholder, partner, or member of the entity that owns the property. GBBON COUNTY AUDI • :
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Recorders ot5ce where contact is recorded Record number Page
_ __ _ _ - '_?-c: PRORERT,DESCRIPTION,?4jt _ e. .- '� i =,
Carey
'Township^ Twang dsaid( ,town,IownNip) •
Parcel number I Legal dezmption Is the property in question: - -
Oi � 440.e., t eal property ❑ Atmuaey assessed noble home(IC 6-:.:-Ty
If any portion of the tesiderc al structure or the and not exceeding one(1)acre that immediately surrounds Nat stricture is used to produce income.desmbe the use and nonio n
of hie property oozed to produce inane.
a !I - /y _ / g - /0/ - 060. ,ZOO - DD G
PROPERTY OWNED ELSEWHERE BY CLAIMANT
Sate.County,and Township Is claimant vacating a homestead?
❑ Yes ❑ No
S'• . re ofdatrnam
I hereby certify the above statements are true,correct,and complete.A / / /s./
Address of mean(number and and ZIP Ode) r • vacated home, d any(umbe a street dy,state and ZIP code)
3'CI s. .4.-7 - A• -
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 I plus line 2) (3) I I
Residential improvements or Dwelling (4) I
Annually Assessed Mobile I
Manufactured Home Garage (5)
Other improvements (6)
Total improvements(line 4 through line 6) (7) I I
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.
VeCying action-Signature of Aoddor Date signed(month,day,year)
�_. '�5y =STANDARD DEDUCTIONALLOWANCE�'�-•;:.+, ;7—a = aw
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 $
that is not assessed as real property or to a manufactured home that is not assessed as reel pmperty may
not exceed one-half(VR)of the assessed value of the mobile home or manufactured home.
Signature of Auditor N Date signed(month,day,year)
DISTRIBUTION: Original-Covey AWtu,FieSamped Copy-Taxpayer