HomeMy WebLinkAboutHomestead_Kirby z• CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
-K \ STANDARD I SUPPLEMENTAL DEDUCTION FORM
State Forrn 5473(R15I5-14) HC10
v Prescribed by the Department of Local Government Force
INSTRUCTIONS:See reverse side for filing instructions.
NOTE:Telephone,Social Security,driver's license,state identification and federal identification numbers are confidential under IC 6-1.1 .e- r
CERTIFICATION STATEMENT .) - i -
I(W e) i' -fl a'. • •' tilt ' 1 )oc upied as mY(our n : I
place of residence or- (are)buying the following described real property •rider contra I. which a�ieomestead PropeW Tax Standa:
Deduction is hereby claimed on the date this application is signed, (date of sgnaturaP£IpJek
. SOwn, El Am(are)buying under recorded contract. 42 8011.
❑ 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 quall a•::i -"..4.-t .-i rust_
III Am(are)the shareholder, partner, or member of the entity that owns the property. (,`QU Y�'y�•
r i
It Ewing on contract Fee singe owners name
Reorders o5ce where comae is recorded i Record number 1 Page
County I Township •Taxi. disT^t(d ,town,township•
Parcel number Legal desoigion Is the prooppeerrttY in question,
o\ •�
Weal properly ❑Annually assessed morale hone(IC 61.1-7)
It any portion of the residential ea 'are or the land not exceeding one(1)acts that immediately surrounds that structure is used to produce income,describe the use and potion
of the Dmperty utilized to produce income_
a to-I-7 -01-f - '1100 • 70 5 00 Li OA I.
PROPERTY OWNED ELSEWHERE BY CLAIMANT
sate,County,and Township Is claimant vacating a homestead?
❑ Yes ❑ No
Signature of claimers
I hereby certify the above statements are true,correct,and complete. lCp /J J� _ .
Address of contact(number and weer,rid.state,and ZIP code) /'\ of vacated homestead,I any(nu and street,oily,tea ,and ZIP code)
! a',: 75-74 • - ( i. 6G.f
ASSESSOR USE ONLi ASSESSED VALUE I HOMESTEAD VALUE I NON-RESIDENTIAL
VALUE
Land not exceeding one(1)acre immediately (t)
surrounding residential Improvements
Other land (2)
Total land(line I 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 pia line T) (6)
I hereby certify the above is true,correct, Signature of Assessor Date signed(month,day,year)
and complete.
Vedy'ug aeon-Signature of Auchtor Date signed(nmlh,day.year)
_ ,7 ,fi-i- _- _:t .STANDARD DEDUCTiON ALLOWANCE=- >___ '" ,=_°_-�: 7W
20 pay 20 Lesser of 60%of the assessed value of the homestead or$45,000
Nobtithstending 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(1/2)of the assessed value of the mobile home or manufactured home.
Oats signed(month,day.year)
DISTRIBUTION:Original-Couny Audio,Fle-&ed Copy-Taxpayer