Homestead_Richardson (2)""� CLAIM FOR HOMESTEAD PROPERTY TAX
? STANDARD / SUPPLEMENTAL DEDUCTION
Sr. _ Stata Form %73 (R72 / 609)
�° / PresaiCed by Ne Departrtianl a1 L.aml Govemmerrt Frerce
INSTRUCTIONS: See ieverse side fo� filirrg inshuc(ions.
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APR 2 7 2012
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I(We) l certitytha�,�( C���i
place o( residence or am (are) buyin ihe following described real property fw which a Homestead Property Taz S�aBdS
���,,,u___,,,n���(((der conVact on the date Ihis application is filed, (date of filing): �
�I(We) awn ❑ Am (are) buying under recorded conVact
Am (are) entitled to occupy as a tenant-stockholder of a cooperelive housing corporation
� Have a beneficial interest in ihe Wst or Ne right to occupy the property under ihe tertns of a qualified personal residence Wst
tt buying on wntrad, Fee Simple ownefs'uma
mnVaq is
Township
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Ommis frenu / Identifcal
a aa�„a�� �w� r� a; �
Orivers license I ICentificalion I ONer number
ot daimarrt's sP�se (lasl rive
Record number Page
: mwn.f9nnshiv) �
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ParcrJ number � Leg31.Q � tim / I Ihe perty' qu�tion:
6 L R,,.
�II rtion ot the resdential strucfwe or Ne land nol excee01�q7 (7 � that um�etliacely w IF �"+ used
m vem wm�a m woe� �e.
ojG_/�-/G-/�-QU�%���/
-,. , , : . �9�
Counb Township � Cwnry � �
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I hereby certiy the above statements are We, cortea and complete.
Pdtlress(numberaMSbeet.dty,slate.anOZlPCOae) �
Und not ezceMing 7(one) acre Immedfatety
aurtounding resitlential improvemen5.
OtherlanC
7otal land (line 1 plus line n
Residential Improvements or Annualty ��ling
0.uessed Mobile I ManuFaceireC Home Garage
Ottier ImpfovemeMs
7otal improvemenh (fina d through Ifne 6J
Total value (Ilna J pllc line n
I hereby certify the above is true, cortecl,
and wmplete.
Veifyirig aUion - Sig�yie o(P�M"itor
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(z)
(3)
(4)
(5)
(6) .
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20 _ pay Zq _� Lesser of 60% of the assessed value o� Ne homestead or $45,000
Notwrlhsfantlug eny oNerpm�ision, Ne wm ol Ne dedurl:ona provWeE in IC bf. f-f2 fo a mo6de Aame Na( k� $
not essessetl as reel properry a to e manMawred home Net'a not ssseeced es reel propeM mey nof exceed
30y essessed rtrodle home (IC 61.7-
inc«ne, aesmbe the use and portion
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xmship
Date signad (rtronlh. daY.1��)
Date %f8ned (rtwnth. tlaY.Yea�
Date signM (monN. daY. l��)