HomeMy WebLinkAboutHomestead_Collins (18) s_- CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
r STANDARD I SUPPLEMENTAL DEDUCTION FORM
' State Fenn 573(R15/5-14) HC10
Prescibed by the Decal-mem of Local Gove noera Finance
INSTRUCTIONS:See reverse side for filing insftuctbns
NOTE:Telephone,Soda/Security,driver's bcense,slate identification and federal identification numbers are confidential under IC 6-1.1-12-37.
..+ ;-... . •.�1 - -.s CERTIFIP.ATIONSTATEMENT.. .-?` :_ -1 )FT'. IP•.'/)
I(We) IQ N fOS e P,/ /N S certify that I(we)occupied as my(our)pnn.•-
place of residence or am(are)buying the following described real property under contract for which a Homestead Property Tax Standard
Deduction is hereby dawned on the date this application is signed, (date of signature). I(v4f)p O
❑ Own. ❑ Am(are)buying under recorded contract '1 ` r COS
❑ 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 peg.•:, -- .� :st, .
❑ Na (are)the shareholder, partner, or member of the entity that owns the property. �N(J0 7�p-er
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If bcyfrg on contrast Fee Sbnple owners name - + -.��
Recorders of5ce where roam S recorded • Record number Page
• s a9Ma's-_' eitttl-:.sitet .mot PROPERTY,DESCRIP-TION c` Sca
County Township T::.trict(cjy,town, ")
.c/ tiS
Parcel number Legal de pSOn ' / 7 is t e petty in question
2c ,/1 /s �•/ Real popery ❑Amualy ascacl anted home(IC&i.1-7)
If any penal of the n�..ial structure r the land not exxceecLg/ol��(/'71.))a acre:hat[[ltit th,fxdaay sundads/ `tat cnumae is used to produce incor e.descibe the use and portion
of the property ttTC ad to seduce hon.
of�a///52_/0 V. OO4a 0.30-O42
_ •PROPERTY OWNED ELSEWHERE BY CLAIMANT
Sea,Carty.and Tdwnstip Is claimant vacs rag a homestead? -
. ' ❑ Yes ❑ No
rI hereby certify the above statements are true,correct,and complete. / ..O
/ a �
/ sleet city,state ZIPMee) /r 'Addrsf related Lwmekead,d any(number and street city,stab,and LP code)
ASSESSOR USE ONLY I .ASSESSED VALUE I :HOMESTEAD VALUE NON-FtESI
VALDE�AL `
Land not exceeding one(1)acre Immediately a-'- "=
surrounding residential Improvements I(1)
Other land (2) _Y. __ ,x_.. 13.
Total land(fine I plus line 2) (3) - - — _ _
Residential Improvements or Dwelling I(4)
Annually Assessed Mobile/
Manufactured Home Garage I(5)
Other improvements 1(6)
Total improvements(line 4 through line 6) (7)
Total value (line 3 phs line 7) I(8)
I hereby certify the above is true,correct, I Signature of Acv--r Data signed(nwA day,year)
and complete.
Vertyi-g action-Signature of Nddr Data signed(month,day,year)
z.' T r�-7�v7 _1agrF,,,..e:_• q'STANDARD,DEDUCTION'ALLOWANCE r;"'-,z'�-=-z-'C s`
20 pay 20 Lesser of 60%of the assessed value of the homestead or 545,000
Notwithstanding any otherprovitlon,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 properly may
not exceed one-half(12)of the assessed value of the mobile home or manufactured home.
Sigraare otaxf.tor Date signed(rain,day year)
DISTRIBDnnON:O:igbal-County Audit Fie-Sanged Copy-Taxpayer