HomeMy WebLinkAboutHomestead_Kramer (14) a� CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
4.c41, STANDARD/SUPPLEMENTAL DEDUCTION FORM
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State Form 5473(R151 5-14) ¶ 3
Presented by the Depa7nerrt of local Govenvnent Finance lr@Q!L/Y1/--
INSTRUCTIONS:See reverse side for filing instructions
NOTE:Telephone,Social Security,drivers license, ate identification and federal identification numbers am contdenfial under IC 6-1.1-12-37.
1. 1�•• " . "Ii 1/. CERTIFICATIONSTATEMENT::.':'� ' `ML'�"..h; s�• �•1
I(we) _ �1IT .,.iij talk
certify that 1(we)occupied as my(our)principal
place of residence•jam(are)b s e following described real property under contract for which a Ho - tead Pro•- T- Sta.•ard
Deduction is hereby-aimed on ate this application is signed, (.:t�of +. It, as e):
u Own. ❑ Am(are)buying under recorded contract GIBSON COUNTY AUDITOR
❑ 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.
___-. �_
.
If buying on wneact Fee Shnpie owner's name
Recorder's office where contract is recorded • Record number Page
f4r`lI IESA 1`:-.. itu-T`aT ' 'PROFERTCADESCRIP-TION,„.' A..'-,{�•"�"<--
I
Inter:bet Legal daaaipW i '`,/ I�\'h�e/pmlperty n questiw:
�p1.8._ 3-40a b$1.gyJ-.QJL ealproperty ❑ AnnuaP/assessd=tee bome(IC6-1.1-7)
If any portion of the residential structure es the lad not esQadag ore(1)acre that Immedately surrounds that structure Is used to produce income,desaibe the use and potion
of the property utilized to produce income.
. ' 1 PROPERTY OWNED ELSEWHERE BY CLAIMANT , - . . ,
state,Caaay.and Toverelt Is claimant vacating a homestead?
Li Yes ❑ No
Signatve of I hereby certify the above statements are true,correct,and complete. \ n
Address of mmad(number and street city,gat,and ZIP••,. of a d d,if any(number and greet oly.gate,and ZIP code)
'302 Al• .:.-7 ` • ;M ita. .Z.rr -
ASSESSOR USE ONLY ASSESSED VALUE` I . -.
HOMESTEAD VALUE • I L NON ESISIDENTIAL
Land not exceeding one(1)acre immediately .-•
surrounding residential Improvements I(1) I -_ _'
Other land (2) (,-.^.sin . _
Total land(line I plus line 2) (3) -
Residential improvements or Dwelling (4) _
_ tt.-?4;v'“.
-.
Annually Assessed Mobil e/
Manufactured Home Garage (5) - Ti' `- j
Iv . .�ti:aI__
Other improvements (5)Total improvements(line a through line 6) (7) I
Total value (line 3 pits line 7) (6)
I hereby certify the above is true,correct. Signature of Assesses Dais signed(month,day,year)
and complete. ppvv
Y...s.y action-Signature of PUdo is irwd( yI a,) t
W_ 3" - STANDARUDEOUCTONALLOWANCE Ty'`- Lam _ :>
20 pay 20 Lesser of 60%of the assessed va'ue of the homestead or$45,000 MAY 2 2016
No ''Wending any other provision,the sum of the deductions provided in IC 6-1.1-12 to a mobile home $
that . ot assessed as real properly or toe manufactured home that is not assessed as real property may
not:• gone-halt(12)of the.ssessed value of the mobile home or manufactured home.
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DISTRlBUrloN:Origgnal-County Adfm Fla-Ma/aced Copy-Taxpayer