HomeMy WebLinkAboutHomestead_Bobbitt (4) ,K_•_. CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
a_ y \\a STANDARD I SUPPLEMENTAL DEDUCTION FORM
./ State Fenn 503(R1515-14) HCI O
• % Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for filing instructions.
NOTE:Telephone,S bial Security,driver's license,state identification and federal identification numbers are confidential under IC 6-1.1-12-37.
- CERTIFICATION STATEMENT' 1 '
I(We) t(✓1Wla"E`(�- I`=! certify that I '. e •.iupi is a o ) Mr.-I
place of residence• m(are)buying the following described real property under contract for which a Homestead Property Tax Standard
Deduction is hereb 95.imed on the date this application is signed, (date A�J! n ture).2l I )
El Own. El 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 a qualifi rsenal ' Just.
❑ Am(are)the shareholder, partner, or member of the entity that owns the property.
_ _ _
_ ..
If buying on contract.Fee Simple owner's name
Recorders office where contract is recorded Record number Page
tom- _ 1c:'. _ '-a:''-PROPERTY,DESCRIPTION t'.s. -ci"^`._.-_--a _ _'.> .-W-?__
lawny Township Taxing distract(city,tom,to ashy)
Parcel number Legal ale a�-L&-103 11 Q.QQ ❑R I is al
i property ❑Annually assessed mobde home(IC 6-1.1-7)
If any potion of the residential sTC or the land not exceeding one(I)acre that immediately surrounds that structure is used to produce income,describe the use and portion
of the property uazed to produce income.
PROPERTY OWNED ELSEWHERE BY CLAIMANT
Sate,Camay.and Towns-tip Is claimant vacating a homestead?
0 Yes 0 No
9�:azure of daimam re a
I hereby certify the above statements are true,correct,and complete. featu ,
Address of cwrad(number and stsset/�y,tare,and ZIP code) .{nom hid• •wares:•- ' ead, any umber aA et ary,state,and ZIP code)
ASSESSOR USE ONLY I ASSESSED VALUE I HOMESTEAD VALUE I NONRESISIDENTWL
VUE
Land not exceeding one(1)acre immediately (t)
surrounding residential improvements
Other land 1(2) I
Total land(line I plus line 2) I P)
Residential Improvements or Dwelling I(4) I
Annually Assessed Mobile/
Manufactured Home Garage (5)
Other Improvements (6) I
Total improvements(line 4 through line 6) (7) 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.
Votfyirg action-signature of Aud•:or Date signed(month,day,yeas)
20 pay 20 Lesser of 60%of the assessed vSue 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 AUG 6 O��
that is nostmt.,
s real property or to a manufactured home that is not assessed as real property may
not excee12)of the assessed value of the mobile home or manufactured home. `lnl�'-'
Signu]ae o `,!'/ e(i� )slid N/ ro� i
DISTRIBUTION: Original Coos-Cy MA:7x.Fie-Stamped Copy-Taxpayer GIBSON COUNTY AUDITOR
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