Homestead_Leech CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
STANDARD/SUPPLEMENTAL DEDUCTION FORM -
1- State Form 5473(R151S14) HOW
Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for filing instniab+s
NOTE:Telephone,Social Security,driver's license,state identification and federal identification numbers are confidential uncle 1.i 12 (7 )
;lOTr• v C. . ,•CERTFICATONSTATEMFM..Nth a. 7. 1x1 r i.!,127. r ti_ f $
I(We) ��/Ayr/ fninP a k/rtify that I(we)occupied as my(our)principal
place of res7 nce or am(are)buying the following de -•-• real prope •nder con.-0 or which a Homestead PriiippOr Tpx
Deduction is hereby claimed on the date this application is signed, (date of signaltAl I e):
❑ Own. ❑ Am(are)buying under recorded contract I
•❑ Am (are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation. V 0.
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified •-•(•- ITOR
❑ Am (are)the shareholder, partner, or member of the entity that owns the property. GI
-
If buying on contact Fee Simple owners name
Recorders oMoe where con=is recorded - Record number Page
Wita .era yTr --'` 3 `f ? P.ROPERTY;:WSC IIifION'
Toemship
r :).4 I a
'asW/number .mss//'' �' I legal deavt]m Is the property in q�Y.im 1�,�
</�/01—c ) 06, -0 •13 Real property LV.Nnua%assessed mobile home(IC fit.t-7)
If any Parton of the tnw•ntal structure or the dna not exceeding QxV(1)acne that vnmeda:ey surrounds that=inure S used to/prod-um income,describe the use and portion
of the properly uaaed to produce income.
_ PROPERTY OWNED ELSEWHERE BY CLAIMANT _,
Sax,Caney,and Tow alip Is claimant vacating a homestead?
. - ❑ Yes ❑ No
Synxure of as
I hereby certify the above statements are true,correct,and complete. 1y�� /(f� •Jo
Address of contact(number end me)e�t Pty.date,,end�ZIP�code) / Rldress oi�ec/X.M MrtrWd,if any(nu. and .. e,end ZIP code)
4.
ASSESSOR USE ONLY. - ASSESSED VALUE I • HOMESTEAD VALUE I` NON-RESIDENTIAL'4t,'
Land not exceeding one(1)acre Immediately i,Tr. �''-'
surrounding residential improvements (1) _itic.a ti" .:.u4i:_.
Other land (2) Y
Total land(line I plus line 2) (3)
Residential improvements or Dwelling (4) ^'i' j�.- ,<'.-; _-'.t
Annually Assessed Mobile I
•Manufactured Home Garage 5 p `' ''
-
.rte,=rt {-.-:,•`.
Other improvements (6)
Total improvements(line 4 through line 6) (7) I
Total value (line 3 pits line 7) (8)
I hereby certify the above Is true,correct, Signature of Assessor Date signed(month,day,year)
and complete.
Verifying action-Signature UNduor Date signed(month,dey,year)
"i T ' STANDARD DEDUOTIONfALLOWANCEMG � � - •e�'�W-
20 pay 20 Lesser of 60%of the assessed value of the homestead or$45,000
Notwithstanding any other provision,the sum of the deductions provided in IC 51.1-12 to a mobile home $
that is not assessed as real property or to a manufactured home that is not assessed as real property may
not exceed• e-half(12)of the arse -•value of the mobile home or manufactured home.
Signature of if• • Date sign eta Drexel day,
D -BUMS: anginal-Camay AUd a.Fie-Stamped Copy-Taxpayer