Homestead_Thomas (10) r - CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
it �-. STANDARD I SUPPLEMENTAL DEDUCTION FORM
� State Form S473(R15/5-14) HC10
Premmted by the Oeparment of Local Govt.....e Finance '
INSTRUCTIONS:See reverse side for filing instructions
NOTE:Telephone, • "al Security,driver's license,sfa•identification and federal identicntion numbers are confdential.under IC 6-1.1-12-37.
-7//' . - :C�ERTIFFIICATIONSTATaIENT-'- `t-> 'a -:;'c J�14-
I(We)1� /1 �L�l_ '�r.(StJ_, 0 •rtify that I(we)oc spied as my(our V•••-:l
place of residence or am(are)b mg the fo,• 'ng described real property and if•ntract for which a Homestead Property Tax ..nda
D udion is hereby claimed on the date tNs application is signed, (date of signature). I(We):
Own. 0 Am(are)buying under recorded contract Sr
0 Am (are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation. /0q. -46....1)
O Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified pie Dial resi•- ce tmsI
O Am(are)the shareholder, partner, or member of the entity that owns the property. __�a666b ea,
Recorders office where m o nbao recorded Recorders I Record number Page
.41112
v £7.7.,, Ns,s - - ?.-`e PROPERTY;DESCRiPTION -L%a4�s2.. >xa'a1si'Tir ,.F.
� :-: ►i ;Aria. - < Ail
Parcel ecnber Legs descriptor' I the pro rty in question
cal property 0 Annually aamed retie tome(1C 6-1.1-7)
If ' of the residential stature or t e larid not excKS-g one(1)acre that imedtaiel stn de:a is used to produce inane,dnmte the use and portion
of utilized to prod• income.
- v - PROPERTY OWNED ELSEWHERE BY CLAIMANT
Sate,Couray,and Township Is claimant vacating a homestead? I
FclaErnant ' 0 Yes 0 No
I hereby certify the above statements are true,correct,and complete. /al X Addmdcomac mr nutls eejC gale,e dZPcode) amad hod Gad.• (numbe lid Pee oY gaga dZIPcode)
I t S t.J —erincc,*cx\ .S-A- L41
Land not exceeding one(1)acre immediately ' T- -
surrounding residential Improvements I(1) _ _1-,-s_
T-.
Other land (2) - - - •a."±
Total land(line 1 plus line 2) (3) - _ — _ -_
-
Residential Improvements or Dwelling (4) -_ -V= ` �- - �;
Annually Assessed Mobile I
Manufactured Home Garage (5) - 4 if '.,'T
Other improvements (6) _ _.22.--, . r
Total improvements(line 4 through line 6) (7)
Total value (line 3 plus line 7) (8)
I hereby certify the above Ls true,coned, Signature of Aesessa Date signed(month,day.year)
and complete.
Vafyig scion-Sgraam ofAVetor Data signed Oncrah,day,yew)
-.pas_ fi ygc sa i;�,}� �`t; STANDARD DEDUCTION'AL'LOWANCE `�3$-`_y;z:'y d+`-,-''+y y`
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 64.1-12 to a mobile home $
that is not assessed as real property or toe manufactured home that is not assessed as real property may
not exceed one-half(1/2)of the assessed value of the mobile home or manufactured home.
r Sigre-ae of Aud:or Data signed(nnxh,day,year)
DISTRIBUTION: Original-County Au6.or,F5-&ed Copy-Taxpayer