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Homestead_Taylor (20)CLAIM FOR HOMESTEAD PROPERTY TAX FORM v�nR �: STANDARD I SUPPLEMENTAL DEDUCTION Hcto � Sta's Form 51]3 (R15 / St<) � P�ewibM py Ne 4 Nnem of lnml GwemneN Fvm�e � INSTRUCTIONS: See revBrSB g0e for fi�u�g instrixfibns. ' � NOTE: Tefephme, Sotlal Securdy, tlmrs Leense, stata idenfi5ca:im and letleral idenu,icalion numhars are con.5tle V� � � I (VJe) • ceftify that I ��place of residence or m(are) bu}nng the foll " described real property under conVact for which ; � Dedu�ion is hereby aimed on the date Ws apptiq5on is signed, � ❑ O+m. ❑ Am (are) buying under remrded contracL ❑ Am (are) enULed to occupy as a tenant-stockholder of a coope2tive housinq corpora5on. ❑ Have a benefidal interest in Me Wst or ihe right to ocwpy the pmperty under the terms of a ❑ Am (are) the shareholder, partner, or member of the entity that ovms ffie property. iw.�aa��,:n��,emai , � i r Narx at tlainarS's s, oiee Satlal5evL5y nurt.xr of < � 11 py4q on cm.'a2 Fee: % � / . Imaa::sbUavaV.�V � � � spouze (la5 frvo 0y3s) I Dmmfs Gcers I Idr�C6m:ion I O'.M o/ dzmzN's syou�e (lesf f,x 6gLSl G1.7-12-37. (date o(signafure). I (VJeJ: JAN 2 9 2016 Pape PaemJ nw�her I �c9a� aeamC� I Is Ne property in puesSOn � ❑ Real P�P�RY ❑��N assessN moCie Mme (IC 61.1-�/ d+m wn«i m �'�e msaeny� uumm a ck um nm eimee,y me c�) � mm'n,ec�r.dr �,� w� r�co a:am m am� �:K. eev—iee c�e �se w pr o, of Cn PoPe+�' �M m RvOUm'uwne. ,��- ���o�-�oo_ �6y.�a9_oa� I hereby ceCify the above sta[emenfs are We, mrtec� and mmple;e. � mY}yt(numba�e�CSlme� � 5afa eMZf .-^,y / � .I'V` //'],I 5� �; kA1�F11 :� � .� I Ll/J v acre OMer Wntl ToQI lantl (line 1 plus I/ne Z� ResiEential improvemanb or Dwemng Mnwlty Assessetl Mobil¢ I ManvfacWmd Homa Ganpe Other impravemenm Todl improvemen� (//ne d Nrovgh lina 6) Total value (line7p!`c lln¢ � I hereEy certify Na abova Is W¢, cortect and campleN. v>en,9 ,a«� - s�+re a a,a��.� Sgraaae of Attessar l; daunant vam^_'ng a homes.wA7 ❑ Yes � No tlaviuN n w � �C .es:atl,Emry(numE a5.aet.�;.tab,uNLPade) •i_ ._ _i-�. '_' —_'_ ' _ _ "_;,�': ' �.p` - .:�-'- _- _._ _ " _" �a:e s6+W (moN/1 EaY. Yee� Dax vS. E (maCh EaY.YeM 20 _ pay 20 _ Lesser of 60% of ihe assessetl v�ue o1 Ne hwnes:eaC w Sa5,000 AbMifhse�✓rg xny ahe�provision, Ne sum ol Ne tleduUions pmvl0ed in IC 6-f. f-12 fo a mobile hwne S Nar is rrot assesmd as real pmperry w to a manif.aclured home Nef k rmt esmssed as real propartymay rrof exceed one-haH(7Q) o! Ne a.aesxd vaNeW Ne mobie home wmenufadured Mme. ol5iwaurwN: �na �-fain+bnua::o..ReSam�EGovr-raparer