Homestead_Schneider n CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
_a_ 1 STANDARD I SUPPLEMENTAL DEDUCTION FORM
i• State Form 5473(R15/5-14) HC1 0
Presoibed by the Department of Local Goverment Faun
INSTRUCTIONS:See reverse side for filing instructions.
NOTE:Telephone,Social Security,driver's license,slate identification and federal idenrl;Nation numbers are confidential under IC 6-1.1-12-37.
- - CERTIFICATION STATEVENT" ' .' '`-=1' s
I(We) w//�/ � certify that I(we)o .( p- (o ) n..- �}
place of residence or ami eluying the fo,• 'ng describ-•re. property under contract for which a Home ∎-.d • •pe ax .ndard
,�Dedduction is hereby cla-.ed the date this application is signed, (date of signature). I(We):
ff De
+Own. ❑ Am(are)buying under recorded contract. AUG AU � 2 8 2015
❑ 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 perso residen
❑ Am(are)the shareholder, partner, or member of the entity that owns the property.
_ _
;'s . ' p„ -_ `^:
It hying on contract Fee Simple owner's name •- - ./.."'
. .. 4
Recorder's office where contract is recorded Record number Page
.,-.h .• ,. r - a,41_,.-
-. -AW.: PROPERTY DESCRIPTION tee ` .4.y.. �5..t '"7f-
Cut
Toetsfp I T tricr(oily,tone,formable)
1 Parcel number Legal description / Is the property
j!^al property ❑ Annudey assessed mobie home(IC 6-1.1-7)
II any patron of the resident al stuct or the land not exceeding one(I)eae that'sn Viate y sunoundsss that Mucture is used to produce- e e the use and Forth'
of the property united to produce income. Lasi
a -/7—/ 6 - 300 7o5 �3/Q opt .
I
Sate,County,and Township Is claimant vacamg a homestead?
❑ Yes ❑ No
Signature of clamant
I hereby certify the above statements are true,correct,and complete. y
j�Q 'Address f as(number and greet ai5t stare,'malt� l/`` of vacated homestead ar-(number a brew.arty,sate,and ZIP code)
V? `�I��L7! 5 I ii�IL• a /// 6
ASSESSOR USE ONLY I ASSESSED VALUE I HOMESTEAD VALUE I NON-RESIDENTIAL
Land not exceeding one(1)acre immediately I(1)
surrounding residential improvements
Other land 1(2)
Total land(line 1 plus line 2) I(3)
Residential improvements or Dwelling I(4)
Annually Assessed Mobile I
Manufactured Home Garage (5)
Other improvements (6)
Total improvements(line a through line 6) (7)
Total value (line 3 pis line 7) (6)
I hereby certify the above is true,correct. SgruYre of Assessor Date zoned(moral,day,year)
and complete.
Veityi g action-Signature of Auditor Date signed(north,day,year)
' _ _ ._STANDARD DEDUCTION ALLOWANCE=T.._C .a �
. .�_� ::j•-=-t?`'' -
20 pay 20 Lesser of 60%of the assessed value of the homestead or S45,000
Nohlilhstanding any otherpmnsion,the um of the deductions provided in 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-half(1/2)of the assessed value of the mobile home or manufactured home.
i z_ 6 P Date ed(mon*d^ay.year)
DISTRIBUDON: Orginal-Cowry Auditor,Fie-Samped Copy-Taxpayer