HomeMy WebLinkAboutHomestead_Bean CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
;C. -i:, STANDARD I SUPPLEMENTAL DEDUCTION FORM
.�it> State Form 5473(R15/5-14) HC10
'•:-.1 Prescribed by the Depar en:of Local Government Finance
INSTRUCTIONS:See reverse side for fling instructions.
NOTE:Telephone,Social Security,drivers license,state identification and federal identification numbers are confidential under IC 6-1. - 2 37. .
-CERTIFICATION STATEMENT - -.t '
I(We) A R_.011 S tiro WW- sat, certify that I(we)occupied as my.(our)principal
place of residence or.1(are)buying the following described real property under contract for which a Homestead Prope�{Ca StTanddard
Deduction is hereby claimed on the date this application is signed, (date of signature). I(We)! 4 20 5
❑ Own. ❑ Mn(are)buying under recorded contract.
❑ Mn(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation. GslepR�.n�,s� - , •_�
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified pema.yres 's?Thz
❑ Am(are)the shareholder, partner, or member of the entity that owns the property. NTYAUi(T
•
Recorder's cf5 a where cent-act S recorded Record number 1 Page
r' _ _3- <'v. . .._�..r.PROPERTY DESCRIPTION' max.-'!tr=r%••e- - :� ,; -z`i:
CT:
C�r A •
�-' l Township ng di Taxing (cry,town,townshWp)
I vN
. .-u number
legal desaipton I Is the property in Question:
proper try ❑Annually assessed motile home(IC 6-1.1-7)
If any Cortion of the residential tram Or the land not exceeding one(t)acre that icvnedatehr surroi4s that structure in used to produce income,descnbe the use and pot 1
of the property u.v¢ed to produce income.
dd- 6 0.17.too-o 601
' PROPERTY OWNED ELSEWHERE BY CLAIMANT
I Sate,Loamy,and Towstio Is claimant vacating a homestead?
❑ Yes 0 No
Signature of Bain m
I hereby certify the above statements are true,correct,and complete. {/���//t
Address of contact(number and sneers arty state,and ZIP code) Andress of vacated y(number and street,oft',state,and ZIP code)
x ao8 _ . .<
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 Nine 1 plus line 2) I(3) I
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 (tine 3 plus line 7) (6)
I hereby certify the above is true,correct. Signature of Assesses Date signed(month,day,year)
and complete.
Varying acion-Signature el Auditor Date signed(month,day,year)
,e ' ;...a:= - : . -:r 2gti 3;STANDARD DEDUCTION'ALCOWANC s'-r a_,'•`,=•2 a =-`�� '"•e_:Y_:q=r.'=_
20 pay 20 Lesser of 50%of the assessed value of the homestead or$45,000
Notwithstanding 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-halt(1/2)of the assessed value of the mobile home or manufactured home.
Signature of AUCMOr 'Date signed(ninth,day.year)
DISTRIeUPON: Original-County Aud.tos FeeSamped Copy-Taxpayer