Homestead_Key CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
Arfat STANDARD/SUPPLEMENTAL DEDUCTION FORM
State
te Form 5a(R15/5-14) HC70
Presoibd by the Department Finance of Local Government once
INSTRUCTIONS:See reverse side for filing instructions.
NOTE:Telephone,Social Security,driver's license,state identification and federal identification numbers are confidential under IC 6-1.1-12-37.
I(We) _ 1L certify that I(we)occupied as my(our)principal
place of residence or am(are)buying e o owing descri real property under contract for which a Homestead Property Tax Standard
Deduction is hereby claimed on the date this application is signed, (date of signature). I(We):
❑ Own. ❑ Am(are)buying under recorded contract
❑ 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 temps of a qualified personal residence trust .
❑ Am (are)the shareholder, partner, or member of the entity that owns the property.
If bry'ug on contact Fee Simple owner's name
Recorder's o5ce where contact is recorded • Record number Page
61,74_7..x`3 ¢i sL1-a_?': . ! 3 -? $,T-r `ss-APROPERTY,DESCRIPTION=-as.t.�.t.:2 .- .4211 ;%--',-r`_4
■
County Township Taxing ds:id(city,,torte,lotwi4Jp)
Parcel number legal desoiprion Is the property in questimm
❑Real properly ❑Annually assessed noble home(IC 6-1.1-7)
If any porban of the resift-dal toucan or the land not exceeding me(1)acre that'm med6ey surrounds that structure is used to produce income.describe the use and ponies
of the property taaced to produce nmrne.
96 — la- % - 3ou - Cog, 3&o -crag
PROPERTY OWNED ELSEWHERE BY CLAIMANT .
Sate,Camy,and Township Is claimant vacating a homestead?
' ❑ Yes ❑ No
Si31:re of di:.va
I hereby certify the above statements are true,correct,and complete. "—S-6-24444e. •
Address of (number and greet oty,stab,and ZIP code) Address of vacated Iu...aaad,R any(number greet city,gate.and ZIP cak)
q U) 1 tiara. ST prim nce 4t N
ASSESSOR USE ONLY I ASSESSED VALUE.0 'HOMESTEAD VALUE I NON-RESIDENTIAL
VALUE
Land not exceeding one(1)acre Immediately (1)
surrounding residential Improvements ._Other land (2)
Total land(line 1 plus fine 2) (3) _ _ _
u Residential Improvements or Dwelling (4) -• 0 ' -
' Annually Assessed Mobile/
Manufactured Home Garage (5)
Other Improvements (6)
Total improvements(line 4 through line 6) (7) 2 2 �s O 7 L
Total value (llne3 plus line 7) (6) JU ZOib
I hereby certify the above Is tine,correct Signature of Assessor Date signed(month,day,year)
and complete.
Vey-dying aeon-Signature of Aodtor ,. ,day.year)
IBSON •OUNTY AUDITOR
rte%`- L?a -'RSTANDARODEDUOTION'ALLOWANCEa&WMatE a
20 pay 20 Lesser of 60%of the acseccnd value of the homestead or 545,000
Notwithstanding any other provision,the sum of the deductions provided in IC 6-1.1-12 toe 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-halt(I/2)of the arse value of the mobile home or manufactured home.
SigruMae or _a . l' e RIB Drs `am y
i„
DISTRIBUTIOON:OrigiW-Cowty
Audta.Fie-Samped Copy-Taxpayer y