HomeMy WebLinkAboutHomestead_Carter (5) At. CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
�1 STANDARD/SUPPLEMENTAL DEDUCTION FORM
State Form 5473(R15/5-14) HC10
Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for filing instructions. •
NOTE Telephone,Social Security,driver's license,state identification and federal identification numbers are confidential under IC 6-1.1-12-
_ -0ERTIFICATION STATEMENT t: s :' " - '""r-..: I:t N 2'i..-' . )
I(We) 2 -MJ_11_"1L/ .", - ceridy that I(we)occupied as m r)•,t1[
I
place of residence or am(are)buyi 2 the following described 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(Well c 7 2 0 2016
ID Own. ❑ Am(are)buying under recorded contract U 1.I L� 2016
❑I Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation.
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified personal residen4 a vl i a/
❑ Am(are)the shareholder, partner, or member of the entity that owns the property. fY �•s
• • • TY AUDITOR
°
-
if buying on contact Fee Simple owners name
Rem-dets office where rats is recorded • Record number 1 Page
i i'r `ire -•e_:z3'= c"^ r:"r `="is�rPROPERTY,DESCRIP,TION-.�'. ii^ Ass ..'' --. -'-.-:• 3V
County To ship 1 Tax gr-• }' -torn,tOWIL�')
/Cl/l7ra/v1
ar
Parcel number' Legal desolation Is the property m guess=
Abml property ❑ Annually assessed noble home(IC 6-1.1-7)
d any potion of the resdemal=-.rate or the land not exceedthg one(1)ace that immediately srmeunds that aifucture is used to produce income,describe the use and portion
of the property Waded to produce Inca e.
076_/0 _/$ - -7° —c?c0 377 oaf
PROPERTY OWNED ELSEWHERE BY CLAIMANT- - ' ' _ .
Sta_,Casty.and Township Is claimant vacating a homestead?
. ' ❑ Yes ❑ No
Signature of damara
I hereby certify the above statements are true,correct,and complete. _,_.,e__ , 44/ ,
Address of contact(number end street ray,Sete,end ZIP rode) Address of vaao'sd hagrxead.sani(number and slree4 Yx=6.e,and LP code)
'P0 9 -/tit - >4 I ?✓.tit ti SN 4***>6no
ASSESSOR USE ONLY - .ASSESSED VALUE I HOMESTEAD VALUE .I ';NON VEASIIDENTIAL
Land not exceeding one(1)acre Immediately .--. +f
surrounding residential Improvements (1) F`.1:•;'•- i -t -„CA_..
Other land (2)
Total land(fine 1 plus tine 2) (3) - - - __ -
Residential improvements or Dwelling (4) � 3 ) T
we
Annually Assessed Mobile/
Manufactured Home Garage (5) _ 4T. ?" .may ti 1
- c _
Other improvements (6)
Total improvements(line 4 through line 6) (7)
Total value (line 3 pis line 7) (6)
. I hereby certify the above Is true,correct,
Signature a Assesses- Date signed(=oak day, ea
and complete.
Verifying action-Slgrabre of Ausir Dan signed(mmd4 day,year)
t-5--- '+7s_-_` 'a.�TZri STANDARDDEOUCTION'ALLOWANCE'e!D-:11' � :_`==.-;t=`=—='-D..=�-. �_�a
20 pay 20 Lesser of 60%of the assessed vGue of the homestead or$45,000
Nohiihstanding any other provision,the sum of the deductions provided in IC 6-1.1-12 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(12)of the assessed value of the mobile home or manufactured home.
'Signature o L OF Date signed(nadt day.year)
L 4402in -rtfii /0-c:7 U76
DISTRIBUTION: Orighal-County AW:a,FleSamped Copy-Tas aver