HomeMy WebLinkAboutHomestead_Gardner (2) ^ CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
`de* STANDARD/SUPPLEMENTAL DEDUCTION FORM
State Form 5473(R1515-14) HC10
J Presmbed by the Department of Local Government Finance
n.
INSTRUCTIONS See reverse side for fling instructions.
NOTE:Telephone,Sodal Security,driver's license,state identification and federal identification numbers are con!ideate!u •- • -1 al.
' .. • :- ' . — GER'IFIC/MON STATEMENT -' _ : • f t p 1 '![-_-1-:7,14' i
7 � ,
I(We) I•t�� 'q _ . ��f!•-•�at certify thatl(we)o•. •ied ! - +'-
place o residence or am II b / •the f••• 'rig described real property under contract for which a Homestead Property Tax Standard
Deduction is hereby claim-•on •- date this application is signed, (date of 5-i nayllp). ne)2015
El Own. El Am(are)buying under recorded contract. JUL V U J
El 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 pe sldp .
❑ Am(are)the shareholder, partner, or member of the entity that owns the property. ]JiIYML-�JfN{.IAA
a
If buying on contract,Fee Simple goers name
Recorders o'Sce where contact is recorded Record number Page
i-.: r t ._ r— = : :i7-CSi'+— -c:PROPERTY DESCRIPTIONa�- _-.. 'A '__.' _-?r__
=�'-
Cony ToxnsNp Taxing district(oty.wan.1 al,)
la/P---cool number Legal desmp:ion Q Is the property in question:
b •1 O-04-7M�a I Q 1 1 ❑Real Property El Annually assessed mobile home(IC 61.t-7)
If any portion of the residerkial soca a or the land not ezmedt g one`�(1)acre that vrunMref wrtourds that=same is used to produce income.describe the use and porton
of the property utilizes to produce L'got'e.
R&r 4-3-9 71? 8 (SC.
IS:ars,Carey,and Township Is claimant vavtn a homestead?
❑ Yes ❑ No
Sign t of dainam
I hereby certify the above statements are true,correct,and complete. /7
Andress of contact In and t date,and ZIP t Address of va bon .renumber and shell ZIP code)
ASSESSOR USE ONLY ASSESSED VALUE I HOMESTEAD VALUE I NON-RESIDENTIAL
VALUE
Land not exceeding one(1)acre Immediately (1) I
surrounding residential improvements
Other land (2)
Total land(line 1 plus line 2) (3)
Residential improvements or Dwelling (a)
Annually Assessed Mobile/
Manufactured Home Garage (5)
Other Improvements (6)
Total Improvements(line 4 through line 6) (7)
Total value (line 3 plea line 7) (8)
I hereby certify the above is true,correct,
Signature of Assessor Date signed(nmdr,day,year)
and complete.
1 verifying action.Signature of Auditor Date signed(month.day year)
T - '='z__, -c''a,FitSTANDARO DEDUGTON ALLOWANCE_ '— ;! ti's`-+., _ - ` .4,1
20 pay 20 Lesser of 60%of the assessed value of the homestead or 545,000
Not'4thsfanding any other provision,the sum of the deductions provided M IC 6-1.1-12 to a mobile home S .
that is not assessed as real property or to a manufactured home that is not assessed as real property may
not exceed one-hal )of the assessed value oft bile home or manufactured home.
1 Senata'e of Aud or Datet ed('seer day.yee
DISTRIBUTION:Ongial-Geary Aud.tor,FieSamped Copy-Taxpayer