HomeMy WebLinkAboutHomestead_Guess�'""' CLAIM FOR HOMESTEAD PROPERTY TAX
�4._ STANDARD/SUPPLEMENTAL DEDUCTION
State Fortn 5473 (ft12 / 6-09)
�O � Prescribed by the Department of Lo�l Gwemment France
INSTRUCTIONS: See reverse side far filino instmclions.
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� M/e) , ceniy thatG(Re��BiSpR��TrtYY lo�ir7 p���pai
place of r idence or am (are) huying the following described real property for which a Homestead Pmperty Tax Standard Deduction is hereby daimed
under mnVaa on Ihe date Nis appiication is filed, (date of filing):
❑ I(We) own ❑ Am (are) buying under recorded� conVact
❑ Am (are) enGtled to occupy as a tenant-stockholder of a cooperative housing corporation
� Have a benefidal interest in 1he wst or the nght to occupy the property under the tertns of a qualified personal residence wst
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N of tlaimani (Iegal namej
Seamry ruurba d daonant (6sf frs d.q3s) DrivcYs luxnse I Itlentifiption /
$orial Securiry number of tlaimanPS spouse (WSt Irve d'rgds) �rivels license / IdentifuzYOn / Olher number Issuing State
of daimanPs spouse (Ws( frve dlgits)
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If buy'v�g an contrad, Fee Simple ownefs riame
Remrtlels aRre where mnVact is remrded Retord num0er Page
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�nry Township Taring DistriG (riry, mwn. township)
ParvJ twmber �e9al tleutiDUon S.4 93 ��' Is lhe in question:
w • 3-i �: � �� VroPeM AnnuaM assesutl rtwbile fmme (1C &1.1-7�
�tl any por�im of Ne 2sidential swcW re w Ihe Iand not exceedi�g one (1) aae that immeGiately surtounds t swcWre is used to produce iMane, descnbe the use anC portion
of ihe pmperry wTaed fa pmduce income.
I��-i�-llo-�oo-ooy. bos-oa.�
... . . : .
Counb TownshiP CountY Township
I hereby certify the above sta[ements are We, cortec[ and complete. signat re r aai m �
Ad4re�rvimDerantl'street.� s(ate,0en0(.V e� e , � /e ���
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Land not exceeding t(one) acre immediatety ;r�',r�'� �.'�'5i� �°r'`�� `'`
surtoundin residentialim rovements. ��� ��- �"���. �� ��"
Other land (2) �F`� � ��Y���`
-:=�:x r.`+'a'k. `
7oU1 land (line f plus line 1) (3)
ResidenllallmprovementsorMnualty �Iling (4) .ti���.y=��.�%�':�.st-y."'�g�„�r�.{�
Psscssed Mobile I Manutacturetl Home Garage (5) 'j -Yc'� �'� � ` � � ¢'� � �;�
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a. 'n � sae+. < �t �`' _
b �s s?S: eT ..� �
Other improvements (6) � i ,,;._,.,� x
7otal impravements (line 4 through Itne bj (7)
Total vatue (llne 3 plla line n (B)
I hereby certify ihe above is true, cortect, Sigriawra af Assessor Dace signed (mmth, eay, yea�
and complete.
VeiN�n9 aGion - SiBnature of f�udilor Date signed (rtronth, tlzY. lee�)
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20 _ pay 20 Lesser of 60% of [he assesseC vaiue ot �he homestead or $45,000
AblwiNSteMing any alherproWSion, tlre wm o/ the deduct'qns provided in IC 6-f.1-f 2 ta a mobde home Nat is S
rwi assessetl es real property a to a rrenufeaured home fhel a nof assessetl as real piopeny maY �t erceetl
ane-hatl (1R) W Ne assessad rdlue o! fhe mobile hwne wmenulaGwed home.
SignaWre ot itnr Date signed (monU�, day, yea�