HomeMy WebLinkAboutHomestead_HensonM"" CLAIM FOR HOMESTEAD PROPERTY TAX yi
:E_ �; STANDARD I SUPPLEMENTAL DEDUCTION FORM
Sa;eFrnm5493(R15/S14) HC�� 15
��" P�esaiCM Oy Ne DepafineN of lnGl GovemmeN FinaMe
INSTRUCTIONS: See 2verse vtle /or filing inslrucfions.
NOTE: Telepfwie, Satlal Secunry, Orive/s lirense, sfa.e identd�caubn arid lederal idenlifica(bn numbers a�e con:Menlial under IC�,1yj-3�- "
I(We) °�' certify that I(we) ocw�d as�y (&r�r
place of re ence or am (are) buying th �ollowing descnbed real property under wntraa for which a Homestead Property Tax SU
Deduction is hereby daimed on the da:e this application is signed, (date o7signa.c�po'(�(Vg):
1`7
��. ❑ Am (are) buying under recorded contraa.
❑ Am (are) entitled to occupy as a tenant-srockholder of a cooperative housing wrporation. /��
❑ Have a bene5cial in;erest in Ne Wst or ihe right to occupy ihe pmperty under ihe tertns of a qualiied persona���,qppe
❑ Am (are) the shareholder, partner, or mem6er of Ne entiry that owns the property. _ T'W� �� �
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FEeaetleh o5a wnae mn:aa tz,ewrded
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Paecd rnmber Legal Eezui(Fix� Is Ne paperty in ques�art
C� ��� ��nl /e.[-1 �RealMOOe�Y ❑/�%asusseemoWeMmell�
If arry poMon ot Ure �esitleMial sY�xNre or V�e W�q nol exceMig one (t) acrt Vut'vn �eCiY.ey su `WS Wt sttuCUre is uxc ro pnEUm'eicone, Oesm�e Uc use aM
d Lb RoR��Y �:l¢ctl to W�uce'uKLme.
2�O-i�-o�- �o I -aw.3�� -6aa
Sa:e, Cour¢y, am ioxmNp I5 daiman: rdra�rg a MmesteaC
� Yes � No
Slare:ureoftlauwnt _ .
I hereby cer'�fy Ne above sta;emenis are true, cortect, and comple;e.
ldarecs
Laoe
SIBB( �'.Sd:P,
acre
Other Wntl
ToGI IanE (lina 1 plus line 1)
Residenital improvemanis or
Annually Assassetl Mobile /
ManufachireE Home
s . �.� I���
I�Z�
(3)
Dwallln9 (6)
Ganpe (5)
Other improvemencs
Taql improvements (line 4 fhiough lin¢ �
Todl valu¢ (line 7 pl1s line ])
I h¢reby certi(y the above is We, correct,
anE comple[e.
otlwtlitw
n)
(B)
Sgna:ura o: Assessor
20 f� pay 20 � Lesser o! 60% at the assesseE value of t�e homestead or Sa5,000
NW�.ifhstarMirrg any o(herprovision, Ne svm of Me deCUU:ons providad in IC 51.1-/2 ro a mabile home 5
Naf is nof assessed as real pmperfY orlo a manufacfured Iamelhat is nof assessed as real pmperty may
rpf exceed me-ha7(iR) of (he assessetl vaNe o1(he mobde homa ormanW.dCured Mme.
OISTRIBUTiON: Otqv^al � CquNyNC'.'.w. Flo-SanpeE Copy - Tazpaytt
NOV 6
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