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Is the property in question:
❑Real property ❑ Annually assessed moWe Mme (IC 6-1.1 -7)
If any portion of the residential structure or the land not exceeding one (1) am that immediately surrounds that structure is used to produce income, describe the use and portion
the property utilized to pmdure Income.
LJ Ni»
Count' Township
County
Township
1 hereby certify the above statements are true, correct and complete.
Signature of clai
Joe
Address umber and steel, city, state, and ZIP code)
S Dai��Gn
�d lOs 1 S ?S
Land not exceeding 1 (onej acre Immediately
aMCa
surrounding mill , tlalim cis.
Otherland
(2)
Total land (line 1 plus line 2)
(3)
Dwelling
Residential Improvements or Annuafty
(4)
Garage
(5)
i`76.. c Pill,
Assessed Mobile I Manufactured Home}?
- Z
Other Improvements
(6)
c`'Y tpr
Total improvements (line 4 through fine 6)
(7)
Total value (line 3 plus line 7)
(8)
I hereby certify the above Is true, correct,
Signature of Assessor
Date signed (month, day. year)
and complete.
Verifying action - Signore of Auditor Date signed (month. day, year)
• • • .
20 pay 20 Lesser of 60% of the assessed value of the homestead or $45,000
Notwithstarding any otherprovision, the sum of the deductions providrd in IC 6-1.1 -12 to a mobile home that is $
not assessed as mat property w to a ronufacfumd home that is not assessed as real pmpery may not exceed
tine -had (12) of the assessed value of the mobile home or manufactured home.
Signature of Auditor
Date signed (month, day, year)