HomeMy WebLinkAboutHomestead_Goebel CLAIM FOR HOMESTEAD PROPERTY TAX I YEAR
STANDARD/SUPPLEMENTAL DEDUCTION FORM
kr. Sate Fonn S473(R1515.14) HCTO
Prescribed by the Dearenem of Local Government Finance
INSTRUCTIONS:See reverse side for filing instructions. •
NOTE:Telephone,Social Security,drivers license,state identification and federal identification numbers are confidential under IC 6.1.1-12-37.
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 Property Tax Standard
Deduction is hereby claimed on the date this application is signed, (date of signature). I(We):
❑ 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.
°,
If toying on contact,Fee Simple owner's name
Recorder's m ince wrote raroad is recorded Record number Page
."-y'"`! •_ .37?2,-: P.ROPERTY,DESCRIP-i)ON-a!z' Fi rT'r: _.a}_r:
Cam:y Tewrutip /�Tang district(dry,lawn twsnshiP)
Pa - 13 4c2- / • I36 s� S Is❑Property
Real property ❑Annually assessed mobile home(IC 6-1.1-1)
It any paten of the residettbl strCae or the land not exceeds";one(1)acre that irnn edit li um-curds that structure is used to produce income,desolbe the use and portion
of the property tt3ced to produce bootie.
_ - ' PROPERTY OWNED ELSEWHERE BY CLAIMANT v -.
Sale.Carley,and Townstsb Is claimant vacating a homestead?
. ❑ Yes ❑ No
Signature of claimant
I hereby certify the above statements are true,correct,and complete.
Address of mrud(rw:nber and Street cey,vete,and ZIP code) Address oof vacated ha-reseed,i any(number and street city.state,and ZIP code)
IOOE6/*rgtd 6 G/6dC
ASSESSOR USE ONLY , I ASSESSED VALUE HOMESTEAD VALUE lI_- `NON-RESIDENTIAL• .
VALUE•
Land not exceeding one(1)acre Immediately (1)
`_i L--�,ks'•
surrounding residential Improvements
Other land (2)
Total land(line 1 plus line 2) (3) _ - _
Residential or Dwelling (4) '
Annually Assessed Mobile e/ I
Manufactured Home Garage (5) { I I. - --•
Other Improvements (6) -
Total improvements(line 4 through line 6) (7) MA• 9 2016
Total value (line 3 p1w line 7) (8)
I hereby certify the above is true,correct, Signature of As�sa Date signed( • N,day,year)
and complete. irInf ir
vciYi,g ae;an-sgmanre dAUC:« GIBSON Ca UN Y AUDITOR
K'awtFr'. 'see-•ys +STANDARDDEDUCTIONtACLOWANCE -q�� F *_ _
20 pay 20 h ecv.r of 60%of the assessed value of the homestead or$45,000
Notwithstanding any other provision,the sum of the deductions provided in IC 6-1.1-12 to a mobile home 5
that is not assessed as real property or to a manufactured home that is not assessed as real property may
not exceed o aH(V7)of the assessed val of the mobile home or manufactured home.
Sgramne d Putl or . Date sigg4(mg day yegr)
�.`/ /ply/ /'!/f/�'7
DISTRIBUTION:Odgrul-County yAud a.Fie-Samped Copy-Taxpayer