HomeMy WebLinkAboutHomestead_Rainbolt a- CLAIM FOR HOMESTEAD PROPERTY TAX j YEAR
STANDARD/SUPPLEMENTAL DEDUCTION FORM
-i' State Form 5g8(Ri6I Std) HC10
Prescibed by the Department of Local Govern xm FinaMe
INSTRUC]IONS:See reverse side for fling instructions - I l
NOTE:Telephone,Social Security,driver's license,state identification and federal identification numbers am confidential un yr C C. .1-r-37 I,
- CERTIFICATION STATEMENT.'- ._..- _ . . .
A ' .
I(We) s�'e1 lb C. certify that I(we)ocwPbed1m my{{our)Mitaal
place of residence or am(are)buying th= ollov,ing described real property under contract for which a Homestead PF6'pert}Tax StMtkd
Deduction is hereby claimed on the date this application is signed, (date of signature). I(We):
Ovm. ❑ Am(are)buying under recorded contract ,/I`_, �}--qy
Am(are)entitled to occupy as atenant-stockholder of a cooperative housing corporation. )�•,�W(F%il�-�J1N(A.P
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a citigh opermig ATA MDI-OR
❑ Arn(are)the shareholder, partner, or member of the entity that owns the property.
. .
ZI2
If buying on conhad.Fee Simple cts name -_
Recorders o5ce where contract is recorded - Record number Page
S"- ki Cwr;y . . :_..�t.: ._. .- ._1-7-d7 rri :`PROPF3TY;DESCPorTON r v=_n 'ai:r.+. Y:�7M _ ?.z4ir5
Tote
Tang dam' ( T
Pared number •� s 1 Legall desai(p5on ✓� T\ hs the property h que5mn
,P1..-`, •No-a( J I - 0( . l os- )J 1 property ❑Annually assessed noble home(IC 111.1-7)
if any portion of the reside tal nts-e or the lend not e-xceCSg are(1)ape that in:m ade:sty sir:vurds that Catae is used to produce income.describe the use and pot'uon
of the popery tdzad to produce bootie. •• t PROPERTY OWNED ELSEWHERE NY.CLAIMANT', -,. - •• ' - -
SYa,Cairn.and Tbp Is claimant vacatng a homestead?
❑ Yes��_N�o� (y//1�CT/,
Si 1 t<#,daimant G gLG!/iT rsz
I hereby certify the above statements are true,correct,and complete. �,' '^ //�f
Address of comao(number and sheet My,oho,end ZIP code) L.-ess of vacated ha ezlted,d any(number and sheet.ray,.stay,and ZIP code)
l4315 bA""itZ 1 �_ r L/7G7o •r ' ' ASSESSOR USE ONLY - - , I ASSESSED VALUE =HOMESTEADVALUE I 'I -"'NON-RESIDENTIAL - •-t
VALUE
Land not exceeding one(1)acre immediately k,�', `. ¢ �r
surrounding residential Improvements I(1) - _a:+":>
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•
Total land(line 1 plus line 2) (3) - _ -_
Residential Improvements or Dwelling (4) t, ?I "'.'<> ` r f t.
Annually Assessed Mobile/ -- -`
Manufactured Home Garage I ern r� ,-7
g (5)
Other Improvements I(6) 1-_---..s, .'""_ ''^s 4 _
` cur
Total Improvements(line 4 through line 6) (7)
ITotal value (line 3 plrs line 7) (8) 1
I hereby certify the above Is true,correct, 15gnature cfM•-n•z Data signed(month.day.year)
and complete.
Verifying acaon-Signature of A dtor Date signed(month,day,year)
-n-i t - � t7_ -Sr' 35TANDARDDEDUCTIOALLOWNCE b v .?7- _ r - .
20
pay 20 L44-44r of 60%of the assessed value of the homestead or$45,000 }
- • : ir
Notwithstanding any other pmvislon,the sum of the deductions provided in IC 61.1-12 to a mobile home 5
that is not assessed as real properly or to a manufactured home that is not assessed as real property may
not exceed one-half(112)of the assessed value of the mobile home ormanufaGUrfed home. �I�'I1 11 ��16
Sg enre of Aud'or I Des signed 4 ,1,0
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DISTRIBUTION: Odgtwl•Gamey Audcor,Fie-Samped Copy-Taxpayer /
GIBSON COUNTY AUDITOR