Homestead_Majors i
CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
a.' STANDARD/SUPPLEMENTAL DEDUCTION FORM
$��[ye� State P m 5413(R151614)
•,—:'l Presmbed Dy the Department of Local Government Finance
INSTRUCTIONS:See reverse side for fling instructions. .
NOTE:Telephone,Social Security,driver's license,
(date of signature). I(11,4A1
❑ Own. ❑ Am(are)buying under recorded contract. 7 0 jc
❑ Am (are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation. ,r U
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified peefSd t ./,-; _ .
❑ Am (are)the shareholder, partner, or member of the entity that owns the property. CO V1 v/
_ ..- _ -
'Recorders office where contract is recorded 1 Record number 1 Page
c'_ ie '- _a =-._s _e;!t`_. x'e_PROPERTY,DESCRIPTION_Yg'-_, .t-"? �.:.• _ :C;.^.:>ti�.a'
Cou y?. Township Taxing (illy,I• ,I wrssh.b) / •
/ �_ ° ( / ty! .r_
P - number Legal desorption Its the p p^petty in question:
-
eat property El Mnua!y- -?- •mob a home(IC 61.7-7)
If any potson of the residenal so'j re or the lard not exceeding ore(1)acre that immediately turrou, that suudne is used to produce income.describe Ile use and potion
of the property mimed to produco mm
076/v/t ta e-00% /a9o0 7
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State,Court",and Township Is claimant vacating a homestead?
I Yes D No
Signatu-- a' ant / --
I hereby certify the above statements are true,correct,and complete. /, /J//
Address of cornea(number and street city state,and ZIP cede) Address of vacated homiest-- ..y(number%(erdd oy,gate.and ZIP code)
A
ASSESSOR USE ONLY I ASSESSED VALUE HOMESTEAD VALUE I NON-RESIDENTIAL
VALUE
Land not exceeding one(1)acre immediately I(1)
surrounding residential improvements
Other land 1(2) I
Total land(line I plus line 2) 1(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 3plts line 7) I(8)
I hereby certify the above is Vie,correct, Signature of Assessor Date signed(month,day,year)
and complete.
Vadyitig acion-Signature of Auditor Date signed(month,Cay year)
'• - a----cSTANDARD DEDUCTION ALLOWANCE^FU: 11'l - — T —
20 pay 20 Lesser of 60%of the assessed value of the homestead or$45,000
Nohsithstanding 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(i,)of the assessed value of the mobile home or manufactured home_
Signature of Author Date signed Vaasa day,year
DISTRIBUTION: Oryiul-Coury Audtor,File-&amoec Copy-Taxpayer