HomeMy WebLinkAboutHomestead_Williams (17)LA
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CLAIM FOR HOMESTEAD PROPERTY TAX
R STANDARD /SUPPLEMENTAL DEDUCTION
.Y State Form 5473 R12/609)
Presaibed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
MAY 2 2012
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Garage (5)
Other improvements (6)
Total improvements (line 0 through line 6) (7)
Total value (fine 3 plus line 7) (6)
1 hereby certify the above is true, correct, Signature of Assessor Date signed (month, day, year)
and complete.
Verifying action - Signature of Auditor Date signed (month, clay, year)
STANDARD . r
20 pay 20 Lesser of 60% of the assessed value of the homestead or $45,000
Notwithstanding any other provision, the sum of the deduclions provided in IC 6- 1.1 -12 to a =bile home that is $
not assessed as real pmperty, or to a manufactured home that is not assessed as real property may not exceed
one -hall (12) of the assessed value of the mobile home or manufactured home.
Signature of Auditor Data signed (month, day, year) ,
CERTIFICAT10N STATEMENT
I(We) cartifythatlfggYgp>:¢@ NgT*i�}our)1TAIRpaI
place of residence or am (are) buying the followingdescribed real property for which a Homestead Property Tax Standard Deduction is hereby claimed
under contract on the date this apprffli�[[[[r-vaflon is filed, s-'Ib 1 b — c 5a� (date of filing): 07 - -o� 0 / d
C] I (We) own [ zAm (are) buying under recorded contract - -
❑ Am (are) entitled to occupy as a tenant - stockholder of a cooperative housing corporation
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified personal residence trust
INFORMATION
Name of demand (legal name)
'5�o I I ( q
Social Seaatty
Social Security number of claimants spouse (last five digits) Driver's license I Identification / Other number Issuing State
of claimant's spouse (Aril five drgft)
CONTRACT ••r r
it buying 7E5 Fee Simple owner's name
Recorders office where contract is recorded Record number Page
PROPERTY DESCRIPTION
County T
Township Taxing district (city, town, township)
Parcel number L
Legal description I
Is the property in question:
' I
I properly ❑ Annually assessed mobile home (IC 6.1.1-7)
If any portion of the residential structure or the land not exceeding one (1) aae that immediately suroun that structure is used to produce income, describe the use and portion
of the property utilized to produce income. `
`:59 �
PROPERTY OWNED BY
County Township Ccunry Township
I hereby certify the above statements are true, correct and complete. i
ignature of nt '
Add sly ( rand t, r�V" �jIP C
C %G.� %, V �
r HOMESTEAD V
Land not exceeding 1 (one) acre Immediately �-
surrounding residential improvements. (1)
Other land (
(2)
Total land (line 1 plus line 2) (
(3)
Dwelling (
(4) -
- r- •,°3'isryy'i'.
Residential Improvements or Annually
Assessed Mobile I Manufactured Home