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HomeMy WebLinkAboutHomestead_Unfried era. CLAIM FOR HOMESTEAD PROPERTY TAX I YEAR A'•,.} 1i STANDARD/SUPPLEMENTAL DEDUCTION FORM _ State Form 5473(R15/5-14) Prescribed by the Department of Local Government Finance INSTRUCTIONS:See reverse side for filing instructions. i 1 NOTE:Telephone,Soda/Semidry,drivels license,state identification and federal identification numbers am confidential under! • 1.1 ,,I /T .. - ' der �I�sCERTIFICATION STATEMENT.'•- r __ ,1_./' I(We) i f 'i A certify that I(we)occupied A G 6(o )yri II place of residence or am(are)buying the following d- • bed real property under contract for which a Homestead Property T"az Sabdhfp Ded ction is hereby claimed on the date this application is signed, (date ofsignatyre). I(We): Own. ❑ Am(are)buying under recorded contract ❑ Am (are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation. Q�Y7� ❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualifieds personal Oresiidence tA�OITOR ❑ Am (are)the shareholder, partner, or member of the entity that owns the property. 6 buying on contact,Fee Simple owners name Recorders office where corset S recorded • Record number Page -'_' _ of _ t>' i `= Y-FSi PROP,ERTYDESCRIPTION -g'� .�'pE T3jBee-lasss+,q.r s..;;5<"- L- Parcel number i i ^ Is�the l�'R0ealalry in numb=on I A{`/iC/1[�4 i "--worm ❑A^nw0y assessed mobile twine(IC 61.1-7) If any p�vgdt of the d to produce ceurdae or the land not ezcee{ (1)�ge ha Or umou tMS that structure¢used to produce Income,tlesvi0e the use and portion of do���\\\tribnibn verb i to ROm�'em:o. /LL dfriz a% -J3 —off moo —GOO. 7/3—oc2 -. PROPERTY OWNED ELSEWHERE BY CLAIMANT SYe,Carey,and Towrship Is claimant vacating a homestead? ❑ Yes ❑ No Signature darara` �r� I hereby certify the above statements are true,correct,and complete. „A `� 7/ af7d Address of contact(number and street,rd y,state,and ZIP code) Address of vacated omecnd,if any(number meet,cry state,and ZIP code) S D a _ • ■ ku-e . I-, • ASSESSOR USE ONLY • I ASSESSED VALUE 'I .HOMESTEAD VALUE _ I. NON-RySISIDENTIAL Land not exceeding one(1)acre Immediately I(1) surrounding residential Improvements Other land 1(2) Total land(line,1 plus line 2) I(3) - — _. - Residential improvements or Dwelling I(4) _ Annually Assessed Mobile I _ ' „'a" - - Manufactured Home Garage , T • Other improvements (6) `' _,,,* Total improvements(line 4 through line 6) (7) Total value (line 3 pits line 7) (6) I hereby certify the above Is true,correct, I Signature of Assessor Date signed(month,day,year) and complete. Vetyig action-Signature of A&sttr Oats signed(noel day.yam) kileg _aW.STANOARODEDUCTION ALCOWANCEa .v` - 20 pay 20 I rssar 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 5 dial is not assessed as teal property of toe 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. Sgt re of Autlor Data signed(ninth,day,year) DISTRIBUTION:Odgial-Casey As,d a Fie-Samped Copy-Tmmayer