HomeMy WebLinkAboutHomestead_Cansler CLAIM FOR HOMESTEAD PROPERTY TAX YEAR /6/9/7
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e_- STANDARD I SUPPLEMENTAL DEDUCTION FORM
State Form 5473(R1515-14) /
Prescibed by the Department of Local Government Finance
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INSTRUCTIONS:See reverse side for filing instructions. �9X(Q / it - i/ e_
NOTE:Telephone,Social Security,driver's license,slate identification and fed identification numbers a.'confidential uuylr'�a 57
® - CER1IFICAIION STATEMENT' . _ _ + _�, "'
Uwe) r cj — , �i , certify that I i o upl .as • r) . •I
place of residence or am(are)buysp r e fol i'ng described real property under contract for which-ii ome Lea.]Pr.•-i. T. ?�:rd
Deduction is hereby claimed on /ate this application is signed, (date of signature). I(We):
1
❑ Own. ❑ Am(are)buying under recorded contract. APR 4 2015
❑ 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.
❑ Am (are)the shareholder, partner, or member of the entity that owns the property.
a.. miir(H1►i
. _ .
If buying on contract.Fee Smile owner's name
Recorder's&Ste where contract is recorded Record number I Page
. -�+l=v :•`_�2!_.- -r:-�:. . ='PROPERTY DESCRIPTION �;+-:_: .��a'!r--_g±-'...-.��� �S;./=1
Conroy Township Twang dire Orgy tmm.township)
a-Ceda.-1
Parcel number Legal desoiption Is the property in Question
/97 7 N,5 ❑Real properly XPmua%assessed mobee Torte(IC 6-1.1-I)
If any portion of the residential strurdre or the land not exceeding one(I)acre that immedatey surrounds that structure is used to produce income,descibe the use and parson
® of the property n1¢ed to poppy moon*.
E
2 & - y zs - eo3/ 3' DJ a6- bt-,16-aoaeooa4 CID- WO
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State,County,and Township Is claimant vacating a homestead?
❑ Yes ❑ No
A/Signature of otaman
I hereby certify the above statements are true,correct,and complete.
I of contact(number. end street cay vale,and ZlPceda) m:c of noshed ho.l e�d,d any(number and Sheet,cey,Vale.end ZIPCOde)
¢ 1
ASSESSOR USE ONLY I ASSESSED VALUE I HOMESTEAD VALUE I NONRIESISIDENTIAL
UE
Land not exceeding one(1)acre Immediately (1)
surrounding residential Improvements
Other land (2)
Total land(line 1 plus line 2) (3) 1
Residential Improvements or Dwelling (4)
Annually Assessed Mobile h
Manufactured Home Garage (5) ,
. i
Other improvements (6)
Total improvements(line 4 through line 6) (7)
Total value (line 3 pits line 7) (6)
I hereby certify the above is true,correct, Signature of Assessor Date signed(mans day.year)
and complete.
Veuyeg action-Signature of Audtor Date signed(month day.year)
Htz- -,;:L =� tc-e a--":c ry=-' STANDARD DEDUCTION ALLOWANCES„_„ .S O
20_ pay 20 Lesser of 60%of the assessed value of the homestead or 645,000
® Nohtthstanding 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(12)of the assessed value of the mobile home or manufactured home.
Sgnaaturere of Auditor Date signed(math,day,year)
4/w'res't./ )d---"4-1-50----l<
DISTRIBUTION:Original-County Auditor,FeeSamped Copy-Taxpayer