HomeMy WebLinkAboutHomestead_West (2) 4r' _ CLAIM FOR HOMESTEAD PROPERTY TAX FORM I YEAR
-.Ca STANDARD/SUPPLEMENTAL DEDUCTION
• State Form 5413(RI5/5-14) HC10
Prescribed by the Department of I»031 Government Finance
INSTRUCTIONS:See reverse side for filing instructions. . - I- LA, I
NOTE:Telephone, ••< Security,doer's°cense,state identification and federal idenfrcation numbers are..' en on - !Q6- 1- 2-3g ,
- :'-71_ -� . . 'i/ 'CERTIFICATIOH$TATEb1ENr-.• : <)"j J[ �^, -'7.-.7:-..
I(We) -4 1t 1� ENZI U R_ f I PZ! certify that I(we)occlqIel aSi(cyQour)principal
place of residence or am - - buying the followin, described real property under contract for which a Iffa@ to r It Piax Standard
Deduction is hereby dal, S• the date this application is signed, (date of signature). I(We):
❑ Own. ❑ Am(are)buying under recorded contract
❑ 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 term yy igloo -nap r �e OwR
❑ Am(are)the shareholder, partner, or member of the entity that owns the property.
` �
If tasting on contract,Fee Sim*owners name
'Recorders o5a wtere protract is recorded - Read number Page
i;-a 3)s cit= -1- -'2' -d s'ROPERTY,DESCRIP,TIONta- 3el.
Parcel A ]/•�� •(Leegal desaiptko �� // I LL property in quesam
41 ��U-3w 6.� -I as-oast Real property ❑ Annually assessed motile home(IC 6-1.1-7)
If any potion of the resideKbl s5'acae or the land not exae&ag one(I)acre that immedately that sundae is used to produce Wane,describe the use and potion
of the property utilized to produce income.
. -.PROPERTY OWNED ELSEWHERE BY.CLAIMANT
State,Cony,and TownsNp Is claimant vacatng a homestead?
. ' DYes 0 N
SigvW of 'nit n{� I
I hereby certify the above statements are true,correct,and complete. `mat tit n /_ _-}-
Address of Gonad(number and meet,rsy.state,and ZIP rode) L'7(p 3C1 FnNCS of al homestead,it any(number land s^at olyvrate,and ZIP code)
12133 S L-1 o W [40,,,tbs (} ICI
ASSESSOR USE ONLY ' I ASSESSED VALUE it _HOMESTEAD VALUE .,I NON VALDENTIAL
Land not exceeding one(1)acre Immediatsty I(1) -:2-.C-.7.
surrounding residential Improvements - t±--
- -+�-a---
Other land (2) ..: ..:_r-_._;.3:_ti,.tau .A
Total land(line I plus line 2) (3) _ _ __
Residential Improvements or Dwelling (4) I"' -_ ti-;l. -1`tom-,
Annually Assessed Mobile/
Manufactured Home Garage (5)
Other improvements (6) _ .4 ":.- ' _- _..
Total improvements(line 4 through line 6) I(T)
Total value (line 3 plus line 7) I(6)
I hereby certify the above is true,correct,
Signature diktats= Des d . r
and complete. F
VeNy"vg action.Sigra;ure dAuC;or ,II
°`�'4;°i• s- t, �-i -:STANDARDDEDUCTIONAL'L'OWANCE _ y� ?
i. • .
20 pay 20 Lesser of 60%of the assessed value of the homestead or$45,000
AoMithsanding any otherpravision,the sum of the deductions provided in IC 6-1.1-12 to a mobile home $
that i not ssessed as real property or to a manufactured home that is not assessed as real property may �/
not• lone-hal(la)ofthea:•,••value of the mobile home or manufactured home. •�(�(��' D R
i '. .•� ftuoc,, �Ies y�
DISTRIBUTION:Original-Cau'3yAWSr.Fie-Stained Copy-Tas yet