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HomeMy WebLinkAboutHomestead_Ewing Joshua r I', CLAIM FOR HOMESTEAD PROPERTY TAX • YEAR rt L i)‘ STANDARD/SUPPLEMENTAL DEDUCTION FORM State Form 5473(R1515-14) / Prescribed by the Depamnent of Local Goverment Finance INSTRUCTIONS:See reverse side for filing instructions. NOTE:Telep, e,Social Security drivers license,state identification and federal identification numbers are confidential under IC 6.1.1-12-37. CERTIFICATION STATEMENT - - ' • I(We) 'y7ll 'S__;l _ -_u -- certify that I ws (a��yPe0 p Wipapa"T(ON place of t- idence or am(are • ing the following described rea 41;erty under contract for whichB�brhebtp roperty Tax StSt r{duar�f�NS{yf Dedu ; is hereby claimed the date this application is signed, Sl'b� 1�nF�""" ❑ • ❑ Am(are)buying under recorded contract. day O{--- ❑ 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 - •uallfied n �ce trusthud for ❑ Am(are)the shareholder, partner, or member of the entity that owns the property. rP� CiIbSOn GUMS! If buying on contract-Fee Simple owner's name Recorder's office where contract is recorded Record number Page - _ ___ _.. r PROPERTY DESCRIPTIONtc. r et t ,. _ . . ___ ,x'.- -3 County Township .- Taxing district(cry,tone,township) (p�� I number /��] (� Legal description a�P.II 1 hie property in question: /{/( �//�•�/�yLs)+ 13 - aai DO _coo•% •i''l l�Real property ❑Annually assessed motile home(IC&I.7-7) `IIf any pxhon of the residers ia/I rttftae{{a the land not exceed g one(1)ace that{�lately Surrounds that structure is used to produce income.describe the use and potion cite progeny ttd¢ed to produce income. PROPERTY OWNED ELSEWHERE BY CLAIMANT Sate,Couney,and Township Is cl❑aimant vafi g a homestead? / Yes ❑ra No saytr o are 9/ n I hereby certify the above statements are true,correct,and complete. Address of asrn-ac(number en]street My,rate,and ZIP mile) ss• bon eead.a any(number and same&ray,rate,and ZIP code) 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 1 plus line 2) (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. Signature of Assessor Date signed(month,day,year) and complete. Verifying anion-Signature of Auditor Date signed(month,day,year) ._u-LL, 1 `„>, 21 _ STANDARDDEDUCTIONALLOWANCE__ , .s p-;;;W 20 pay 20 Lesser of 60%of the assessed value of the homestead or$45,000 Noteehstanding any other provision,the sum of the deductions provided in IC 6-1-1-12 toe mobile home $ that is not assessed as real properly or to a manufactured home that is not assessed as real property may not exceed 'hall(12)dithe a/sses4wLt4r of the moobb&hhoomee or manufactured home. • fd, :I DY.• ..(^_-'R daY.year) DISTRIBUTION: Onginal-County Aud.:a,FieSampea Copy-Taxpayer