HomeMy WebLinkAboutHomestead_Hasselbrinck (2) .� a CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
A_ 1 , STANDARD/SUPPLEMENTAL DEDUCTION
Sate Form 5473(R1515-14) HC10
+ Prescribed by the Department of Local Goverment fiance
INSTRUCTIONS:See reverse side for filing instructions.
NOTE:Telephone,Social Security,drivels license,stale identification and federal identification numbers are confidenlia n r 6- 1-12-3
I(We) U W/I-0661-° O -tt4 .t- ify that I(we)ocoupi as my our principal
place of residence or am(are)buying the following described real property under contract for which a Homestead�Pr,o{perQty Tax Standard
Deduction is hereby claimed on the date this application is signed, - (date cA4j&t2`O 1 G
❑ Own. ❑ Mn(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 trust
❑ Am(are)the shareholder, partner, or member of the entity that owns the property. GIBSON COUNTY AUDITOR
_y _ .-s.
U burying on contract.Fee Simple owners name
Reorders oflce where contract is recorded Record number Page
_.... ' r-..44.7.711-1;":': . . .PROPERTY DESCRIPTION.. _-=._ _._
County Township Taring dbtdct(city,town,savmslip)
Parcel number /.LL"egal detaipwn (o A L Ile the • perry in clues
1 it Ai 5 4) (49_ 3-i a_ ❑Real property ❑Annual),assessed moGY home(IC 61.1-7)
If any porton of the residential structure or the land not exceeding one(1)acre that immediately surrounds that structure is used to produce income.describe the use and portion
of be properly seabed to produce income.
-210- 17 - /C. , 200 — oo3_ 767 -o 1--/
PROPERTY OWNED ELSEWHERE BY CLAIMANT
Sate,Camty,and Township Is claimant vacating a homestead?
❑ Yes ❑ No
I'Sign]�^of dacwm
I hereby certify the above statements are true,correct,and complete.Ail ( ,_ �nA no 1�^�AA.
1Ad mess of contact(number and street,dry,state,and ZIP code) 414 1I eas of vacated homestead ad, any(numberr and srea4 my state,aced ZIP code)
`11 O ern Ile
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 plus line 7) (8)
I hereby certify the above is true,correct. Signature of Assessor Date signed(month.dog year)
and complete.
Ve-t,ing action-Signature of bettor Date signed(m010,day,year)
..
____ � ' -"�= __= .�"*r°q -STANDARD DEDUCTION ALLOWANCE^ a_ _ ..c d� - �-tl� r
20 pay 20 Lesser of 60%of the assessed value of the homestead or$45,000
Nohvilhstanding 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(12)of the assessed value of the motile home or manufactured Mme.
S9ratufee of�Saal�dyo�rs J�Jr�� /(/� - `/ /� Date sgned(nm:.y day,year)
DISTRIBUTION:Ongial-CotmyAoddor.Fie-Camped Copy-Taxpayer