Homestead_Shaw Repet Form
-4`R' ., CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
x STANDARD/SUPPLEMENTAL DEDUCTION FORM 2024
• State Farm 5473(R191 1-23)
Prescribed by the Department of Local Govemmanl Finance
INSTRUCTIONS:See reverse side for filing instructions.
NOTE:Telephone,Social Security,driver's license,stale identification and Federal identification numbers are confidential under IC 6-1.1-12-37.
CERTIFICATION STATEMENT
I(We)'ShaW. Deborah S '.r._--------
certify that I(we)occupied as my(our)principal place of
residence or am(are)buying the following described real property under contract for which a Homestead Property Tax Standard Deduction is hereby claimed on the
date this application is signed.11-13-2024 (date of signature).I(We): 1
El Own. ❑Am(are)buying under recorded contract.
El 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 qualrried personal residence trust,
❑Am(are)the shareholder,partner,or member of the entity that owns the property.
IIf Buying on Contract,Fee Simple Owner's Name
1 Recorder's Office Where Contract is Recorded Record Number Page
E PROPERTY DESCRIPTION
County Township Taxing District(city,town,township)
G'son 021 Montgomery
Parcel Number Legal Description Is the property in question:
1 ElReal Property ❑Annually Assessed Mottle Home(ICS-1.1-7)
If any portion of the residential structure or the land.not exceeding one(1)acre that Immediately surrounds that structure is used to produce Income,describe theuse and portion
of the property utilized to produce income.
26-17-32-300-001.715-021
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State,County,and-Township Is Claimant Vacating a Homestead?
❑Yes El No
(lgnalu f clalmaSi
I hereby certify the above statements are true,correct,and complete. "r �1�( _,_ r,
Address of Contact(number and street,city,state,end ZIP code) Address'of Vacated Homestead,' any(number and street,city,slate,and ZIP"code)
10280 S SR 165, Poseyville, IN 47633
ASSESSOR USE ONLY ASSESSED VALUE I HOMESTEAD VALUE I NON-RESIDENTIAL VALUE
Land Not Exceeding One(1)Acre Immediately (1)
Surrounding Residential Improvement
Other Land (2)
Total Land(line 1 plus line 2) (3)
Residential Improvements or Dwelling (4)
Pit . '
Annually Assessed Mobile/ ED'
Manufactured Home Garage (5)
Other Improvements (6) NO
ZOZg
Total Improvements(Line 4 through Line 6) (7)
Total Value(Line 3 plus Line 7) (8) CO /
Signature of AssessoP)BSON CO j/ Date Signed(date,month,year)
I hereby certify the above is true,correct,and complete, •
_ QtiAirY �'.14 . )
Verifying Action-Signature of Auditor �"ITOR Date Signed(date,month,year)
STANDARD DEDUCTION ALLOWANCE
20 Pay 20 Lesser of 60%of the assessed value of the homestead or$48,000.
Notwithstanding 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(1/2)of the assessed value of the mo ' home or manufactured home..
Signature of Audrtor /� Date Signed(mon h,day,year)
1/�W ;11 n 1 J 11 14 l?-q2-
DISTRIBUTION:Original-County Auditor,File-Stamped Copy-Taxpayer
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