HomeMy WebLinkAboutHomestead_Julian (2) ` CLAIM FOR HOMESTEAD PROPERTY TAX FORM I YEAR.
STANDARD/SUPPLEMENTAL DEDUCTION
Sat Form 5473(R15I5-14) HC10
Prescibed oy the Depanmem of Local Government Finance
INSTRUCTIONS:See reverse side for filing instructions. ,
NOTE:Telephone,Social Security,diner's license,state identification and federal identification numbers are coniden de 1 C•1.1-12-1' i'1
_ - .:ERTIFI//CC�ATION mammon',z;',7-- ...2 f r 1. en r,
I(We) A A "x 1 al�L - 4_Y1.e,Ih certify that I(we)occupied as my(our)principal
place of residence or am(are)buying the following d.-• bed real property under contract for which a Home A Pr9e%r 7 andard
Dedu is hereby claimed on the date this application is signed, (date mar re. e
Own. 0 Am(are)buying under recorded contract •❑ Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation. � I, • erfilit
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of uItlS j 1 --or1a1(*�?-r OR-
❑ Mn(are)the shareholder, partner, or member of the entity that owns the property. tl5 lJU
: :
.
It tying on contact.Fee Simple owner's name
Recorders o5¢where comma is recorded - Record number Page
,`- t_: r1N`..., e11 si<7_-6-iaAte rb.,4t-a.:c' PROPERTYDESCRIP-TION_at17:7arAWIT:ra --Sr = -
Cosy Tovnship Tas g debit(dbt town,tamshy)
Parcel r.ter Legal desaipoon 1/{/��//�L I Is Me property it Pnstorr
J0-/4�8 -go3-ccn1 r / '��L ' PeoleenY ❑Annual/assessed mobie horn,(IC 6-1.1-7)
If any paten of the residential structure or the land not exceed-sg one(1)ace that innndatey surrounds . stucre is used to produce income.descm±e the use and por5m
of the property utilized to prodtu income.
- . ` PROPERTY OWNED ELSEWHERE BY CLAIMANT 4 •• . ' _ . - - '
San,Covey,and Tomulip Is claimant vacating a homestead?
. ❑ Yes ❑ No
' Sgt of claimant
I hereby certify the above statements are true,correct,and complete. 42140„,,,' lion' /
'Address of canal(n• end street N):afire,end ZIP mce) 1.ness of vacated hames:ead d any( end sreet.rzl:rat,and ZIP code)
— E 'p 0 —/ S _ _a dot
ASSESSOR USE ONLY .I. . ASSESSED VALUE _.I .HOMESTEAD VALUE r NON-RESID'_°NTIA •
VAL:E
Land not exceeding one(1)acre Immediately - - t a
surrounding residential improvements I(1) — !.._::',4_ 4 +�- - '
Other land 1(2) s_G.-�._.. ... .
;.s-'_;,,,w.--.S m.t--_:2+sr>
Total land(line 1 plus I/ne 2) (3) -
Residential improvements or Dwelling (4) I F t A
Annually Assessed Mobile l =
Manufactured Home Garage I(5) • I -..-7i, ,°. r d_^rj_.
Other improvements I(6) 4
>"" - -
Total Improvements(line 4 through line 6) I(7)
Total value (line 3 pits line 7) I(8)
I hereby certify the above Is true,correct, I Signature of Assesspr Date signed(month,day,year)
and complete.
Vvdriy action-Signature ofAud:tor Data signed(nssia day,year)
--, =eZl .a y-F STANDARD DEDUCTION•ACLOWANCE -.ee�^ rs--3?_.:1. J..:'":
20 pay 20 Lesser of 60%of the assessed value of the homestead or$45,000
Notwithstanding any otherprmdson,the sum of the deductions provided in IC 6-1.f-12 to a mobile home S
that is not assessed as real property or to a m ufactured home that is not assessed as real properly may
not exceed on= 12)of the assessed vat of the mobie home or manufactured home. ''T
Sgnx- ofhd::or / -n �/ ) Date sighed yea^
DISTRIBUTION: Origral-County Aud'ea,File-Stamped Copy-Taxpayer