HomeMy WebLinkAboutHomestead_Minnis (11) CLAIM FOR HOMESTEAD PROPERTY TAX .R
•_ STANDARD/SUPPLEMENTAL DEDUCTION FORM
s:`�I:f Save Form 5473(R151 Sta) HC10 1,i�_1■ 'IF
Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse sde for filing instructions.
NOTE:T e l e p h o n e,Social S e c u r i t y,d r i v e r s license,state i d e n t i f i c a t i o n and federal i d e n t i f i c a t i o n numbers are confidential under IC 6-1.1-12-3 r 1 '15
�//� - 'CERTFICAllON STATEMENT -- - t' ' -r-^`^-^?`s'v?r• 7
I(We) /'/(f/'ntirr _ /A, / e • certify that I(we)occupied as my r)principal
place of residence or am(are)buying the f.4. •i7described real property under contract for which a Homestead Prope-.ih, 1-•- 4- e/ •
Deduction is hereby claimed on the date this a p cation is signed, (date of-. - : L.4 qr �'
El Own.Own. ❑ Mn(are)buying under recorded contract •UNTY UDITOR
❑ 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 a qualified personal residence trust.
❑ Am (are)the shareholder, partner, or member of the entity that owns the property.
'
if brMrg. contact.F Situp' (s flaw >27.7e /
&De Recwdels office where contact is recorded Record number 1 Page•
..�'.-i-. >._. _ _ 4.7.PROPERTY DESCRIPTCn•'-"+3 a-t" : ti :-�`--a •2 `-
Ccu y y T Taxing�ory tons //!/0/' /N 414-di Parcel number Legal desaip:ion I Is grte ry in pueYia
eal
property ❑ Annually assessed(noble home(IC 67.1-7)
If any portion of the residential sdudure or the land not exceeding one(I)we that immediately surrounds that structure is used to produce income,describe the use and portion
of the property tt&red to produce income.
dL/7-/7. Jot 60 3. .303- aoP
PROPERTY OWNED ELSEWHERE BY CLAIMANT
I Safe,Caurcy,and Township Is claimant vacating a homestead?
❑ Yes ❑ No
1 I Signature of claimant
I hereby certify the above statements are true,correct,and complete. /JI out ,*tie
Address of contact(number end street.oy,state.end ZIP code) I Address of v ad,d aM(nurrlber and saee4 oty,state,and ZIP code)
ASSESSOR USE ONLY I ASSESSED VALUE I HOMESTEAD VALUE I NONRlESISIDENTIAL
UE
' Land not exceeding one(1)acre Immediately 111
surrounding residential improvements
Other land (2)
Total land(line I plus line 2) 1(3)
Residential improvements or Dwelling (4)
Annually Assessed Mobile I
Manufactured Home Garage (5)
Other improvements (6)
Total Improvements(line 4 through line 6) (7)
Total value (line 3 pits line 7) (8)
I hereby certify the above is true,correct, I sgvtwe of Assesses Date signed(month.day,year)
and complete.
venying action-Signature of Audlor Date signed(month,day,year)
K.: -7-'T',. - a> _ TIT'. z- ,..STANDARD DEDUCTION ALLOWANCE t'_ s-. _-vss" -a'.a['. a`
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 real property may
not exceed one-half(1/2)of the assessed value of the mobile home or manufactured Mme.
Sgnatire of Audeor Date signed(month,day,year)
DISTRIBUTION:Original-County Audter,Fie-Stamped Copy-Taxpayer