HomeMy WebLinkAboutHomestead_Parish CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
rte; STANDARD/SUPPLEMENTAL DEDUCTION FORM
Sate Form 5473(R15I614)
HOW
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-"_ Prescribed by the Depart lea of Local Govenanent fiance
INSTRUCTIONS:See reverse side for frfrng instructions i c
NOTE:Telephone,Social Security,drivels license,state identification and federal'entification numbers a '. .std-i tic(nder I e!�1 1-1�e
.. :,:( • ./-, _ CERTIFICATION STATEMENT , - •:t�• _ _- 1. -tc}' - ,
I(We) 1:���1 - .� 1)f. I ) ;.�- ���certify that I(we)occupied as my(our)principal
place of residence or am(are)buying the •allowing described real prope under contract for which g1i(orrwsteac5 W?Rerty Tax Standard
DeduGion is hereby claimed on the date this application is signed, - H u Ydaa of s4NMVDre). I(We):
❑ Own. ❑ Am(are)buying under recorded contract
❑ Mn(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporatio-,, , - -.id
❑ Have a beneficial interest in the trust or the right to occupy the properly under tiU �•. �'sl residence trust .
�S I 1 Y AUDITO
❑ Am(are)the shareholder, partner, or member of the entity that owns the property. AUDITOR
If buying on contract Fee Supple owner's name
Recorder's o5ce where contract Is recorded • Record number !Page
. lie. . `_0T.r'W__44:7:-. S7=1=" :--2_-7PROPERTY,DESCRIPTION. ._:ti ''%a°� 11 �$�'y ?- �1;i7
`+. Township Tang d9ict(day.town,t )
''' .
Patod rumbv Legal desmp:ion A g 1 dZ� Is Ce Dta
.i(o-Oa-59-o3a-cob 348-o1 .4 a ar A 3 P �Perty ❑Annuay assured mobile home(IC 6-1.1-7)
If any portion of the residential structure or the land not excsMig one(1)ace that immediaey surrounds that structure is used to produce income,describe the use and portion
of the properly cared to produce irons.
• PROPERTY OWNED ELSEWHERE BY CLAIMANT - - -
•Save•Canty,and Township Is claimant vacating a homestead?
. ' ❑ Yes ❑ No
SI(pa'J12 N^
I hereby certify the above statements are true,correct,and complete. //Ip('//T/^J
1Address cwt-as(mamba'and s me(Mx state,end ZIP mode) Address of veered ho es•,ead.Rarty(number and street dY Sxe.and ZIP code)
219 W 5ecc d 6 - -k e�Jot ?v,ti
. ASSESSOR USE ONLY I ASSESSED VALUE I HOMESTEAD VALUE ,' NON ESISIDENTIAL
Land not exceeding one(1)acre Immediately
surrounding residential Improvements (t)
Other land (2) _._•��. :y,,. _„� ..
Total land(line I plus line 2). (3) ..
Residential Improvements or Dwelling (4)
AnnualtyAssessedMobilel _ _'
Manufactured Home Garage (5) rvxn •4 d- °" ' _4
3_-
f1
Other bnprovementa (6) z• _.. ...-.:' - - ,
Total improvements(line 4 through line 6) (7)
Total value (line 3 plus line 7) (8)
I hereby cerOry the above is true,correct, Signature of Assessor Date signed(month,day,year)
and complete.
I Verifying ad»n-Signature o/Aud.;or Date signed(march,day,year)
s3_e�;-a `- ' c-r :-21 STANDARD DEDUCTIONTALLOWANCE - -°,. -' s'
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 toe mobile home 5
that is not -- as real property or toe manufactured home that is not assessed as real property may
not •one-•89(12)of the assessed i sue of the mobile home or manufactured home.
Sgnabm. . .�• Oats signed(nod;day,year)
_A / ` 1�:/�t[..L .a a:—OHS
DISTRIBUTION:Original-County Audibr,Fie-Samped Copy-Taxpayer