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HomeMy WebLinkAboutHomestead_Bruce (6) .-r CLAIM FOR HOMESTEAD PROPERTY TAX YEAR STANDARD/SUPPLEMENTAL DEDUCTION FORM ` - Sate Fan 5473(R15/5-14) HC70 Prescribed by the Department of Loral Govemrent Finance INSTRUCTIONS:See reverse side for filing instructions • NOTE:Telephone,Social Security,driver's license,state identification and federal identification numbers am confidential and 1. 12- . I(We) 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 Prep, rT SteR ag Deduction is hereby claimed on the date this application is signed, (date ofsigndAYeb( III):LU Its ❑ 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 pe e ❑ Am(are)the shareholder, partner, or member of the entity that owns the property. GIBSON COUNTY AU ITOR _ _ .. If buying on contract,Fee Simple wines name Recorder's o5ce where ca bad is recorded Rend number 1 Page ? = `�esna'i.a=rn z;.ir aa..-�' ��c s ...pia" .`sA- ':30 - _- rS.2PROf!ERTY:DESCRIP,TION: ��� County TownsNp Taxing district(city,town,township) �" � "" © s Parcel mamba Legal desaipm Is the p-operynques>m Atoln '�i/�j 7 y .❑Real property ❑Annually assessed noble home(IC bi.l-J) Et any paten of the resident-al stieue or the land not exceeding" me(1)acre IIOU�t ini ediatel `surrounds that suuaun is used to produce Income,describe the use and portion of the property wired to produce eco e. oleo - 1 L/ . / g — /To d - 0°l. ;o 7 - o 0 7 . "- . PROPERTY OWNED ELSEWH ERE BYCLAIMANT Gate,Carey,and Township Is claimant vacating a homestead? . - ❑ Yes ❑ No Signature of davrara I hereby certify the above statements are true,correct,and complete. t.1 _ n , ^ �l _ �'Addtm at mead(number and -- r4Y.strCe,and ZIP... L ( ,. �:jys of a cat/ted)homeseadXd,if any(number and street,Myatt and ZIP code) ASSESSOR USE ONLY • I ` ASSESSEC VALUE I .HOMESTEAD VALUE I - NON-RVALUESIDENTULL E Land not exceeding one(1)acre immediately 1 surrounding residential improvements O Other land (2) Total land(line f plus line 2) (3) - - _ _ _ . Residential Improvements or Dwelling (4) 1:.:,;(171:1U ,.t _ Annually Assessed Mobile/ Manufactured Home Garage (5) _ j"e•;, 's:r /. Other improvements (6) ear _ _ TT'iCr7 ..�_' : Total improvements(line 4 through line 6) (7) Total value (line 3 plus line 7) (8) I hereby certify the above is true,correct, I Signature of...war ors signed(month,day year) and complete. Verifying action-Signature of Audtor Oar signed(month,day.yea) T' -==;,rte = re--- STANDARO_DEDUCTION'ALLOWANCESj Ada 20 pay 20 Lester of 60%of the assessed value of the homestead or 545.000 Notwithstanding any other pmvisian,the sum of the deductions provided in IC 6-1.1-12 toe mobile home S that is not assessed as real property or toe manufactured horn that is not assessed as real property may not exceed one-half(12)of the assessed value of the mobile home or manufactured home. Signature Audta �/—/— Dam sib(+:ox/1 daY.year) DISTRIBUTION: OrigiW-Courtly Auditor,Fie-Samped Copy-Taxpayer