HomeMy WebLinkAboutHomestead_Gillihan .. . STANDARD/SUPPLEMENTAL DEDUCTION FORM
YEAR
Sate Form 5473(R15/5.14)
HOW
Prescribed by the DeparuneN of Local Government Finance
INSTRUCTIONS:See reverse side for li ing insmloions. •
NOTE:Telephone,Social Security,driver's license,state iden&L5cafion and federal ident icaton numbers are confidential under IC 61.1-12-37.
. . _y.r- ', -.
_- - � ,p,I , CERTIFICATION STATEMENT'°,,'_ 1 _� 1.7-r,, : } f� -�'!. .I
I(We)V !�I awn 4L certify that I(we)occupied as my(our)principal
place of residen•irr am(are)buying the fo0owing described real property under contract for which a Homestead Property�Ta!fxpIStandard
Deduwion is hereby claimed on the date this application is signed, (date o/ u Y...i E 9ya--/\p\g �,
❑ Own. ❑ Am(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
❑ Am(are)the shareholder, partner, or member of the entity that owns the property. APR 2 Q 201'
It buying on contract Fee Simple ow:efs name
Remodels oZee where contract is recorded Record manta' Page
County Township •faxing district(may,Iowa tasnsbp)
Parcel=doer A II leeggaldd(esaixm ��ywy�� I ' I Is t.-i tyro pias]wv
26- V 41 to l -303 -vW.4'4o 1 gas. . ❑PmuaM assessed noble hone(IC 6-1.1-7)
if any portion of the residential stuCm or the land not excel rg we(1)acre that inmeoata y surrounds that structure is used to produce income.describe the use and ponin
of de property dived to produce income.
_ - _PROPERTY_OWNED ELSEWHERE BY CLAIMANT __
Sate.Canty.and Township Is claimant vacating a homestead?
. . ❑ Yefi ❑ Noo
I hereby certify the above statements are true,correct,and complete. - I if La/WAS
Address ot=act(mamtxend street,ray.sate,end ZIP code) ` _=.d.Eany((n .6rlet atY.stab,eel LPmde)
• 1 VA. h. 1ra AJUrTln(.�C
t:ASSESSOR USE ONLY - ASSE UE1 °I SSED VAL ;HOMESTEAD VALUE , I NON-RESIDENTIAL-
VALUE
Land not exceeding one(1)acre Immediately -_"r'�--';•`r"-.r c;
surrounding residential Improvements (1) +-- ..-14._71132.7284:,:i'
Other land (2)
Total land(line 1 plus line 2) (3) _ . . - - •- — —
Residential Improvements or DwellIng (4) I
Annually Assessed Mobile/
Manufactured Home Garage
g (5) • I
Other Improvements (6) —"-ez -- '_ "
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 otA«aa Date signed(month,day,yea!)
and complete.
Veify'vp action-Signatrre of Ad:tor Data signed(made day.year)
} -r,rk"STANDARD DEDUCTIONALLOWANCE ..� "+i'C� Z r- a
20 pay 20 lesser of 60%of the assessed value of the homestead or$45,000
Notwithsand(ng any other provision,the sum of the deductions provided in IC 6-1.1-12 to a mobile home $
that is not used as real property or to a manufactured home that is not assessed as mai property may
not ne-hatl(12)oi CL4mobde home or manufactured home. .
. DISTRIBUTION:Orynd-Caaeylvdddor,Fie-Stamped Copy-Tasayer -