Homestead_Bruce (3) CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
rt STANDARD/SUPPLEMENTAL DEDUCTION FORM
State Form 5473(R15I5-14) HCIO
Prescribed by the Department of Local Govcrtment Finance
INSTRUCTIONS:See reverse side for filing instructions. •
NOTE:Telephone,Social Security,drivers license,state identification and federal identification numbers am confidential under IC 6-1.1-12-37.
I(We) ‘,/{ certify that I(we)occupied as my(our)principal
place of residence or am(are)buying the following described real property under contract for which a Horn 1neggrr't T
Deduction is hereby dawned on the date this application is signed, (date HJ to I
❑ Own. ❑ Am(are)buying under recorded contract
❑ Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation. �l���C�
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified perMARre�d®tc2ip1Ep. .
❑ Am(are)the shareholder, partner, or member of the entity that owns the property. 99
If toying on contract.Fee Simple owners name
Recorder's ota where contact c recorded • Record number Page
Cary
Township Taxing d¢trid(cry,town,towns*)
Parcel resider Legal des&stion is the property in c em
❑Real property ❑ Annually assessed mWie home(/C 61.1-7)
H any pot of the residental Smalls or the land not exaedi g ore(1)acre that ice edir.ely surrounds that vnxaae S used to produce Income,describe the use and potion
dale property Leaded to produce bore.
- 05 - 48- 099— (7o3- 0y7?-0i g
„Ira.Canty.and Towrs'vp Is claimant vacating a homestead?
- ❑ Yes ❑ No
Stim of
I hereby certify the above statements are true,correct,and complete. ! a '/cKC-
Address or contact(number arra street,ray,date,and ZIP code) Add vacated homestead,H any(number and street,city,dale,and ZIP code)
I • - �
ASSESSOR USE ONLY I l- ASSESSED VALUE HOMESTEAD VALUE �I , NON-RESIIDENTIAL
Land not exceeding one(1)acre immediately
surrounding residential Improvements (1) E
Other land (2)
Total land(line I plus line 2) (3)
Annually AlsessdeMobts or Dwelling (<) .,? .` --V 3" r yrT
Annually Assessed Mobile/ .Manufactured Home Garage (5)Other improvements (6)
Total improvements(line 4 through line 6) (7)
Total value (line 3 plus line 7) (8)
I hereby certify the above Is true,correct, Signature of Assessor Date signed(comb,day,year)
and complete.
Vmfytrg anion-Signatte of kdtor Date shoed(monM,day.yeas)
r1, STANDAARD DEDUC7I0N 7ALLOWANCE"r'`�31ry=;is. --
20 pay 20 Lesser of 60%of the assessed value of the homestead or 545.000
Notwithstanding any other provision,the sum of the deductions provided in/C6-1.1-12 to a mobile home $
that is not assessed as real properly or toe manufactured home that is not assessed as real properly may
1taL ne-hai(12)of the assessed value of the mobile home or manufactured home.
l r n^�_r v 120X Li Date signed(twee;day.fear)
3 -3o- lb
OISTRI BDTION:Otg?at-County Audbar,Re-Stamped Copy-Taxpayer