Homestead_Duncan ate» CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
STANDARD/SUPPLEMENTAL DEDUCTION FORM
State Formby the(D15/5-14) HC1 O
Presctibed by the Departmem of Loral Govemmem Finance
INSTRUCTIONS:See reverse side kidding instructions.
NOTE:Telephone,Social Security,drivers license,state identification and federal identification numbers are confidential under IC 6-1.1-12-37.
I(We) certify that I(we)oc upi as YYYYYY������ti���PPP tin .
place of residence or am(are)b g the following described real property under contract for which a Homestead , T Stand
Deduction is hereby claimed on the date this application is signed, _ (date of si to
:)Own. 0 Am(are)buying under recorded contract NOV 0 Am (are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation. N 16 'BIB
occupy 0 Have a beneficial interest in the trust or the right to orpy the property under the terms of a qualified personal residence trust .
0 Am (are)the shareholder, partner, or member of the entity that owns the property.
,
± '=
If Wying on contract.Fee Simple axis na-ne
Recorders office where coved is recorded • Record number Page
r t., 1- C. -.._..a':.i_:: a rs HROPERTY,DESCRIP-RON• ,_ -'7.` _:;I':. 9s_e�7- --f>• l-r- y
Gamy
Township Taxigcfstict(d0:tart
question:
Parcel number Legal tlrsoipticn I Is the property W puesdon
o?/ 3- is 1-333�pmpedy ❑AmwA assessed male ome(IC 6,.,-
If any Paton of the resieofal a bee a the end not exceedig one(1)ace that'andseh surtv t!Swan S ued to produce m,describe the use and poi
of the property ordired to produce sane.
--. -. " 0 4, �#471t 3'/ o0
Sate,Carty,and Township Is claimant vacating a homestead?
. ' 0 Yes 0 No
Signature re� � /� /yy-4_
I hereby certify the above statements are true,correct,and complete. ///���
Address of contact(number and street,rdy,Sale,and ZIP code) / Address of vacs , ,cad,a any(number umber eM street day.state,and ZIP code)
/0 L✓ 7�5 �roo.! %.y) 77l-
ASSESSOR USE ONLY r I ASSESSED VALUE . I Y�HOMESTEAD VALUE I NON-RESIDENRAL
Land not exceeding one(1)acre Immediately I
surrounding residential Improvements (t)
Other land (2) v_�. ..._ ..--s- ---a- ,.
Total land(line 1 plus line 2) (3) _ ____- -
•Residential improvements or Dwelling I(4) I •-d^-- '--.. '-
Annually Assessed Mobile I
Manufactured Home
Garage I(5) I r 7.:1`
Other improvements (6) r...''':;::a; =.'d- .v-i:i`.
Total improvements(line 4 through line 6) (7)
Total value (line 3 plus line 7) (6)
I hereby certify the above Is true,correct, Signature of Ac.,-as Date sigxd(month.day,year)
and complete.
Vedyig action-Signature ofAudtor Date signed(n. is day,ref)
Mm
.c LIE312;tMaDM STANDARD,DEDUCTIONAtrOWANCE '7. 0-
20 pay 20 I ester of 60%of the assessed value of the homestead or$45,000
Notnirhstanding any other provision,the sum of the deductions provided in IC 6-1.1-1210 a mobile home $
that is not assessed as real property or to a manufactured home that is not assessed as real property may
not exceed one-half(112)of the assessed value of the mobile home LOP manufactured home.
Sign .or .�/ LL/ Dare signed(month,day,yew)
DISTRIBUTION: Or'igtal-Comfy/0E4-w,9e-Stamped Copy-Taxpayer