HomeMy WebLinkAboutHomestead_Fisher (7) b, CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
STANDARD/SUPUPPLEMEENTAL DEDUCTION
State Form 5473(R15/514) HCIO
Prescribed by the Dena.tnert of Leal Government Fiance
INSTRUCTIONS:See reverse side for;Wog instructions. •
NOTE:Telephone,Social Security,drivers license,state identification and federal identification numbers aro confidential under IC 6-1.1-12-37.
-- - IIV ... _ . .. _-. .GERTIFI.ATION STATEMENT.::. . rr .'..l fir' i. )..}_ I1r- .-7r"t.
I(We) Warn/ rtifythatI( )0.. (.i>.1:s yi• r
place of residence or am(are)buying e foil. n.described real property un. contract for which a •omes ead -co:- •I-, .o .
Deduction is hereby claimed on the date this application is signed, (date of signature). I(We):
❑ Own. ❑ Am(are)buying under recorded contract JUL 2-2 2016
❑ 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 rsonal •.ide .- t -
❑ Am (are)the shareholder, partner, or member of the entity that owns the property. I • •
�I'l�l-e
If buying on contact,Fee Simple owners name •.___
Recorders o°_ce where contact is recorded • Rend number Page
i .rte f'-_ s ._. t.-tip:aa ' . z sRROPERTYDESCRIPTION. `-j-'c -c;��•+._,`;-->W--::ic?rl:C:e= e'tTiN
. ' Toanatp Taslg d5aid(• •)
*,I , n/-►v
`Pa eel number /T•//w�..��/�.,/�.`� Legal desattkai al u the propem to questie°,
a•✓ 'a—✓ a /W ii...� -o a '��/IJ eel RWenY ❑Annually assessed=tie home(IC 51.1-7)
If any portion of the residential stwere or the land not exceedsq one(1)arse that Immediately Surrounds that stuHpre is used to produce income,desmbe the use and portion
of de property'aired to produce hcume. -
_ t PROPERTY OWNED ELSEWHERE BY CLAIMANT• " - . - -
Sate,Corey,and Township - Is claimant vatting a homestead?
. ggqdyy} yt ' ❑ Yes ❑ No
I hereby certify the above s3;zments are true,certect,and complete. �,_(/V b...441/0
'Address of nnbd number and street oily;state,end ZIP code) Address of vacated homestead,i any number and greet city,state,and ZIP node)
105:5 . Se , 4a fez 5h ..
ASSESSOR USE ONLY I' ASSESSED VALUE: I: HOMESTEAD VALUE ,. NONRESISIDENTIAL •
Land not exceeding one(1)acre immediately I(t)
surrounding residential Improvement z 'rte--
Other land (2) cs, _.... _...:____.;..
Total land(line 1 plus line 2) (3) - _ _.
Residential Improvements or Dwelling I(4) �)-.' -`S•,:%`.Na4' z
Annually Assessed Mobile!
Manufactured Home Garage (5) - ..T yFy;,y'
C3-
Order Improvements (6)
Total improvements(line 4 through line 6) (7)
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,year)
and complete.
VerifyirgaCion-Signature of Pa:tor .a•-.'..red d .
) )
i-�y`_s-OZ?er`�.- v- s ="'`± :x='v_.,�.' STANDARDDEDUGTIONAL COWANCEiIP'-`- "{ -ti 7*--°1- = -'_
20 pay 20 Lascar of 60%of the assessed value of the homestead or$45,000
Not ithstandug any other provision,the sum of the deductions provided in IC 6-L I-12 to a mobile home $ JUL 2 2 2016
that is not assessed as real property or to a manufactured home that is not assessed as real property may
not exceedo•: half(f2)of the assessed v/. eol the Taboo home or manufactured home.
Signature d.r.t. I / Drs .. ..!tnt .. . 'a
•.-
DISTRIBUTION:Original-county AuSar,Fie-Stamped Copy-Taxpayer