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Homestead_Spindler CLAIM FOR HOMESTEAD PROPERTY TAX YEAR { STANDARD/SUPPLEMENTAL DEDUCTION FORM State Form 5473(R15/5-14) HC10 Prescribed by the Department 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. (We the ( ) iedas vbu "pal place of residence or am( re)buying the following described real property under contract for whir a Homestead Property Tax Standard Deduction is hereby claimed on the date this application is signed, - (date of si gate.o�I e): ❑ Own. ❑ Am(are)buying under recorded contract JUL y+ L ❑ 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 quali( person ' crust ❑ Am (are)the shareholder, partner, or member of the entity that owns the property. • • - . d buying on contact,Fee Simple owners name Recorder's o'Sa where mreac S ceded • Record number Page DESCRIP.TION:._...'7s Canny TawnsNp Taxing d¢'.ritr(city,lemn.fowrsshp) Parcel natter �LegalMdesaiipioon� Q/�� is the propeM In question: 'a`&,tz o ❑Real property ❑Amualy assessed mate home(IC 61.1-7) II any portion of the pedan:sr S'^nse or the land not exceeding are(1)ate that. :edu:ety surrounds that atutae is used to produce income.describe the use and potion of the property awreed to produce income. OZ 6 i8 - 3 6 3o o0 i 9 72& —0 • _ PROPERTY OWNED ELSEWHERE BY CLAIMANT • - - 53=,Casey.and Townsh Is claimant vacating a homestead? • ❑ Yes ❑ No ^�' of daYn nt I hereby certify the above statements are true,correct,and complete�t'I ie lessof cornea(nu:nber and yraystate,and ZIP rode) 11 IAddress`/ : . and street.rdl:gee,and ZIP code) i 1 /_V/7 w, Z_ berPAA_ I/arks/ddll tg ' 97659 ASSESSOR USE ONLY I ASSESSED VALUE I HOMESTEAD VALUE I NON�ESISIDENTIAL' Land not exceeding one(1)acre Immediately '-'. surrounding residential Improvements (1) Other land (2) Total land(line 1 plus tine 2) (3) _ _ _ Residential Improvements or Dwelling (4) `4-_- --'- °_-__:::y .. Annually Assessed Mobile I _. Manufactured Home Garage (5) Other Improvements (6) — _e _-• Total Improvements(line 4 through fine 6) I P) Total value (line 3 plus line 7) I(8) I hereby certify the above Is true,correct, I Signature of Assessor Date signed(month.day,yean) and complete. Vedyig action-SigrtaOre of Atdor Date signed(month day year) F-y�' ,>'- r =�'Xp`c_ MSTANDARO DEDUCTION ALLOWANCE(= ) °s`y- '; -�'_'.". 20 pay 20 Lecvtr of 60%of the assessed value of the homestead or 545,000 Notwithstanding any other provision,the sum of the deductions provided in IC 6-1.1-12 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 one-half(172)of the assessed value of the mobile home or manufactured home. Signature of Pud:a Date signed(mash.day,year) 4/1elle tint DISTRIBUTION: Otgtal-Camay Auditor,Fte5amped Copy-T er