HomeMy WebLinkAboutHomestead_DeJarnett (2) ,a - CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
-r° - STANDARD I SUPPLEMENTAL DEDUCTION HCRo
State Fom,5473(R15/5-14)
Prescribed by the Oeparbnem of Local Government Finance
INSTRUCTIONS:See reverse side for filing instrurtbns .
NOTE:Telephone,Soda! -• riry,driver's license,flier-identification and federal iden'Ysef)on numbers are mnfden •- I C>s.1-12- : 111
__ CERTIFICATION STC.TEMENT- • , - ',t '-Vi -,1 , 2:4 i_es -
I(We) L _`SIU _!D(IJ _ certify that I(we)occupied as my(our)principal
place of resider).-or am(are)buying the following• . bed real property under contract for which a Homer��''ppg'y andard
Deduction is hereby claimed on the date this applica.on is signed, (date mfrs. e:
❑ Own. ❑ Am(are)buying under recorded contract
❑ Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation. _� �i
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a,4ualr-.11.S.�f '•-' I- C -
1:1 Am(are)the shareholder, partner, or member of the entity that owns the property. 6 CS
:: . ,-
If YYug on contract.Fee Simple oanees name
ReordCs tem where mnSan is recorded Record number I Page
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n sW:- ra.1._14=—riP...-u;� .. :._12.�P,ROPERTYiDESCRIP710NS.r, ,,;u�' a. t--S:L?`:2.1r _T�3i' X'
Zr Township Tamg d5rio •: �:+1 -.:q
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;11x; - ' ..
/-PSlarcel camber /�'� CO3 Legal desoiptot I the proper in question:
l (r-•/ Ia402f C01 • . -0 sal property ❑Pmualy assessed mobile home(/C 61.f-7)
Ve any putce of the residential Cur-re or the land M ea¢edrg ere(1)ace that immediately aemud that structure is used to produce income,desmte the use and Paton
of the property 1=d¢ed to preens income.
- - - PROPERTYOWNED ELSEWHERE BY CLAIMANT - -
Sate,Gamey.and Township Is claimant vacating a homestead? .
. ' ❑ Yes ❑ No
Salt', ,of claimant
I hereby,certify the above statements are true,correct,and complete. C'!�//J1/
Address of aura. numbering state,and P code) T v G 05 dress of vacated homestead,if end s'eef.�:gets.end ZIP COQ)
___ 6729
ASSESSOR USE ONLY 'I ,ASSESSED VALUE I HOMESTEAD VALUE I - NON VESISIDENTIAL' .
Land not exceeding one(1)acre immediately (1) -- t -I
surrounding residential Improvements
Other land (2) ti �"J._.• L--_'rat_ ;
Total land(line 1 plus line 2) (3) - - - - - —.
Residential Improvements or Dwelling (4)
Annually Assessed Mobile 1 _Manufactured Home Garage (5) •
_.,t • __ . A f"'_'.
u-Y
Other Improvements (6)
Total Improvement(line 0 through line 6) (7)
T
Total value (line 3plls line 7) (8) f
I hereby certify the above Is true,correct, signature of Assessor
I• (
and complete. �{
Veityi =San n-Signature of AUdbr gY
T� 9INea)
E _T- ,.STANDARD'DEDUCTION ALLOWANCE = `
��rw�i%
20 pay 20 Lesser of 60%of the assessed value of the homestead or 545,000 •�1%re gOil��a
Nohsth-ending any other provisIon,the sum of the deductions provided in IC 6-1.1-12 to a mobile home G BSON COUNTY AUDITOR
that is • a -ssed as real properly or to a manufactured home that is not assessed as real property may
not es•=...ne-half(1,2)of the a--.. =•value of the mobile home or manufactured home.
sig., A i or Dab sicced(. daY, sr)
DISTRIBUTION: Original-Casey Auditor,FieSamped Copy-Taxpayer