HomeMy WebLinkAboutHomestead_Freels CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
STANDARD/SUPPLEMENTAL DEDUCTION
�' State Form 5473(R15I 5.14) HCIO
Prescribed by the Department of Local Goverranem Finance
INSTRUCTIONS:See reverse side for fling instructions.
NOTE:Telephone,Social Seeadty,drivers iceennnse,state identification and federal identification numbers an confide i un r I 1.1-1
d
I(We) • certify that I(we)occupied as my(our)principal
place of rest ence or am(are)buying the following described real property under contract for which a Homeflt rd Forty(:(.Standard
Deduction is hereby claimed on the date this application is signed, (datg'M'agrfht ).f-P(We):
❑ Own. ❑ Am(are)buying under recorded contract I
❑ Am (are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation.
'q?ins,.
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms oL- .'feu a et -t' -.Wont .
❑ Am (are)the shareholder, partner, or member of the entity that owns the property. Ci JU I U
, _ '
d buying on mftad,Fee Simple cartels name
Recorder's office where contrail's receded Record number 1 Page
F.Cra.4:
v45y 7 V'6 t _ 4. ir:ii:IPROPERTYDESCRIPTON`=ie F ; - .' c s S r„_Cr_
Township
Tmvig ds5ict(illy.town,tus*shm)
Parcel number Legal description Is the property in quesiort
❑Real property ❑Annually assessed motae home(IC 6-1.1-7)
If any portion of the residential sm»ae or the land not esredbg one(1)are that ice eCr ty=rounds that a5umse is used to produce Intone deseibe the tme and portion
of the property dated to produce income.
a6 -1a - 1S - aov - ooI. 01,2 - out 8
•
PROPERTY OWNED ELSEWHERE BY CLAIMANT_ .
Sate,County,and Township Is daimant vacating a homestead?
. ❑ Yes No
)(pomace of
I hereby certify the above statements are true,correct,and complete.
Address of MNad(number and rte):state,and 2/'....) Adaress of vacated homestead,if any(nu greet,d t gate,and ZIP Ode)
frA
ASSESSOR USE ONLY I ASSESSED VALUE I HOMESTEAD VALUE .. I NONRESISIDENTIAL
Land not exceeding one(1)acre Immediately (1) -----7---.7- Tr-__ __�
surrounding residential Improvements
Other and (2)
Total and(fine 1 plus line 2) (3) - _
Residential Improvements or Dwelling (4) - _ ° °g -_
Annually Assessed Mobile I _Manufactured Home Garage (5) _ ,. . _ .-__T-? '
'.s._-__ - :,Tr- i5.-)^
Other improvement (6)
Total improvements(fine 4 through line 6) (7)
Total value (line 3 pfrs line 7) (8)
I hereby certify the above is true,correct, Signature ofPy^�••r Date signed(rtmN,day,year)
and complete.
Vesting action-Sigratre oAudlor Data signed(month,day,fear)
:r- y Rq r W..�"=---Xl + rt—N"STANDARD DEDUCTIONALLOWANCE`V:-.T r-tt t4f= -
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 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(12)of the assessed value of the mobile home or manufactured home.
Sigratur d� —rVC.t--�t� Dab steed(nu-tr,day,year)
DISTRIBUTION: °Nile,-Carey Audtor Fee-Stamped Copy-Tapayer /