Homestead_Miller (6) CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
br}`- STANDARD/SUPPLEMENTAL DEDUCTION FORM
1 Stan Form 5473(R15I5-14) HC10
Prescribed by the Department of local Government Finance
INSTRUCTIONS:See reverse side for tiling instructions -
NOTE:Telephone,Social Security,drivers license,state identification and federal identification numbers am confidential under IC 6-1.1-12-3 C
I(We)''Iof'h e W L, 4-M alor/e 5' ;jie r certify that I(we)occupied as my(our)pdSiE 31 ' 2016
place of residence or am(are)buying the following desoxibed 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):
a
g4 Own. ❑ Am(are)buying under recorded contract I, • COMM.
❑ Am (are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation. f (RSON COUNTY AUDITOR
❑ Have a beneficial interest in the bust or the right to occupy the property under the terms of a
qualified personal sI ence last
❑ Am (are)the shareholder, partner, or member of the entity that owns the property.
--
If tryI g on cortact Fee Simple owrefs name
'Reorders o5ce where ciraad is recorded Record number 1 Page
`x.na. _,v,�.„��f4___'. -.. —SfailP,ROPERTY,DESCRIP,TION-,,;s,42 .. a vT .'-4.”
._' .ta3*_8'".- -ES:
County TovsuNp Taring district((ditty,town,township) '
Panel number legal description I Is theepprroperty N i
Pt5h) 3-�az 3I r �PgPeny ❑Ann assessed monde home(/CS1.1-7)
If any Paton of the �scse or the land notexceedig one ace tint irranedt'sN sdramds that entn is to produce income,dstethe use and portion
of the property noised to R .ace boccie.
dea-/-7-0 I . 36O ono 35y- O a,
• • PROPERTY OWNED ELSEWHERE BY CLAIMANT. _ - . - - ..
Sirs.Canty,and Township Is claimant vacating a homestead?claimant
;-�/� - ❑0 Yes ❑ No
I hereby certify the above statements are We,correct,and complete. I y�e�./LiLK/L- d L
Address of contact(number and street.c/y.sate,end ZIP code) Address of vacated homestead,if any(number and street ray,state,and ZIP code)
Pc :3 70Otd Dumsi/4 X N V665
ASSESSOR USE ONLY I,• ASSESSED VALUE I HOMESTEAD VALUE I NON-RESIDENTIAL - • -
land not exceeding one(1)acre Immediately I(1)surrounding residential improvements
Other land 1(2)
Total land(finial plus line 2) (3) . -- — —
.
Residential Improvements or r Dwelling (4) _ 1-v
Annually Assessed Mobile I •
Manufactured Home
Garage (5) --. `. . 4s9sa
Other improvements I(6) _ •;!?-:`�' __':�r
Total improvements(line 4 through line 6) (7)
Total value (line 3 plrs line 7) I(8)
I hereby certify the above Is true,correct, I Signature of Assessor Date signed(month,day,year)
and complete.
Verdyi g scion•Signature ofAud: r Date signed(month,day,year)
s33 'T��--er r ; s=a`; STANDARDDEDUCTIONALLOWANC�. � sr
20/t. pay 20/7 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 S
that is not assessed as real property or to a manufactured home that is not assessed as real properly may '
not exceed one-half(12)of the accessed value of the mobile home or manufactured home.
c\5/n2[.f,![. L o P Des d(more%day,.h
DISTRIBUTION:Odgial-Couny Aud.:a,Fie-Samped Copy-Tax4 aver