HomeMy WebLinkAboutHomestead_ManionCLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
STANDARD / SUPPLEMENTAL DEDUCTION ;
State Form 5473(R1216 -09) HCtg
S 1 Presrnbed by the Department of Local Government France -f—� ���trr ---
INSTRUCTIONS: See reverse side for filing instructions. y ,
CERTIFICATION STATEMENT
' I (we) certify that I (we occupied as ��1jI {/{of1l1ur) principal .
buying following described for which Homestead Property Tax Stand dlpedJction �0.ldtlby claimed '
place of residence or am (are) the real property a
under contract on the date this application is filed, (date of filing):
❑ 1 (We) own ❑ Am (are) buying under recorded contract O rfa
❑ 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 p91§A9A1sQdbNWR% AUDITOR
INFORMATION
Name of da' t al name) \ ^ /� '
1
Social Security
�
Name of claimant's spouse (legal name)
Social Secunly number of daimant's spouse (last five digits)
Duvets license I Identfxaton I Other number Issuing State
of claimant's spouse (last five dgits)
-CONTRACT ••r .
If buying on contract. Fee Simple owners name
Recorders office where contract is recorded
Record number Page
PROPERTY DESCRIPTION
Co i
Township
Taxing district (city, town, t w hi
krceT number
Legal description
Is the pmpe question:
-001 •
3 —�
I property ❑ Annually assessed mobile home (IC 61.1 -7)
any portion 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
®If
of the property utilized to produce income.
PROPERTYOWNED BY.CLAIMANT IN OTHER COUNTIES
County - Township County Township
I hereby certify the above statements are true, correct and complete.
Siiggnantur claimant '
i
c Address (number, and stree( city state, and ZlPcode)
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jcLj L o I 1
D
ASSESSOR ONLY rr' •
Land not exceeding 1 (one) acre immediately
so voundin residentialim rovements.
�
Other land
(2)
„� ,y,: `�v �•
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
Residential improvements or Annually
Assessed Mobile 1 Manufactured Home
tiara e
g
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(6)
1 hereby certify the above is true, correct,
Signature of Assessor
Dare signed (month, day, year)
and complete.
Vailying action - Signature of Auditor Date signed (month, day, year)
STANDARD DEDUCTION
20 pay 20 Lesser of 60% of the assessed value of the homestead or $45,000
Notwithstanding any otherprovision, the sum of the deductions provided in IC 6- 1.1 -12 to a mobile lame that is $
not assessed as real property or to a manufactured home that is not assessed as real property may not exceed
o (1R) of the arse vat the mobile home or manufactured home.
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