HomeMy WebLinkAboutHomestead_Brown (7) CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
tc 3 STANDARD/SUPPLEMENTAL DEDUCTION FORM
r Stab Form 5473(R1711-10) HCIO
Prescribed by to Department of LoS Government Freres
INSTRUCTIONS:See amuse side for Sting instructions.
NOTE Telephone,Social Searii;md*PYs icons.,state dentdortim and federal itlanttilca&on numbers ate dal under IC 61.1-12-37.
•-�. CERTIFICATION STATEMENT . • ,
I(We) . t e'er o a . {-4_ r1 . certify that 1(we)occupied as my(our)principal
place of residence a am(are)drying the fo0oving described real property under contact for which a Homestead Property Tax Standard
Deduction is hereby claimed on the date this application is signed. (date of signature). I(We):
LzJ"OwrL ❑ 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 a the right to occupy the property under the terms of a qualified personal residence trust
❑ Am(are)the shareholder, partner,or member of the entity that on the property.
.) •--��(\ \ .
a oire an caned.Fee Simile ones name
Recorder's ogee where centred is record Rend reenter Page
PROPERTY DESORIP710N -
Corny Tossehp Taxing deltic((ctyl teat fonrs*i)
_Parcel cutter 'lege desaCCat b Me property it questa
0 Real Potter ❑An olty assessed noble tome(IC 6-L1-7)
If ay Frain of the residential amaze a me lane rid meeting cue(1)acre that inmecidely sounds that attire is tiedb poi®inane,atac a to use aid pacer
of the prtoaty tdred to predominate.
a . SFU- Q \ .
PROPERTYOY(M1ED ELSEWHERE BY CLAIM ff- > ."
Sate,Casty.are Tomtit Is rat vacating a homestead?
❑ Yes ❑ No •
o
a damue
I hereby certify the above statements are true,coned,and complete. /1
Address of mta Adda(number 5 - city,.shoe,and ZIPaaA) sealed lbnvstmd,Patw(mebered street,city,step,and ZIP cad)
10041
- -- ASSESSOR USE ONLY '_ ..i ASSESSED VALUE. HOMESTEAD VALUE r t ot_,RESISIDENTIAL. . - UE .I .
Land not exceeding one(1)acre immediately ",�. s --
surrounding residential Inprovemenb (1) --a' ` 'vf-- .-
as 6 _L
Other land (2)
Total land(lino 1 plus line 2) (3)
Residential Improvements or owNgng (4)
annually assessed mobile I s v Y
manufachad hone Garage (5) -_
Other Improvements (a) -:,tic L':4,L((_
Total improvements(lino•through rare 6) CON 0V
Total vahe(line 3 phis rue 7) (a) 4118
I hereby the above is we,correct, Signature of Assessor Ede signed(r r�-.daY.Wa)
Verifying Wien-Signature oArdbr De awed 411.SCItY
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- - _. ..- STANDARD DEDUCTION ALLOIlANCE '-;� � yTOR
20 pay 20 Lesser of 60%of the assessed vaue of the homestead a S45.000.
Nohfur.ffindirg any otherprovisim,the sum of the ded uceons provided in IC 6-1.1-12 lea noble home S
that is not assessed as teat property or to a manufactured home that is not assessed as neat properly may
not exceed one-half(t?)of the assessed value of the mobile home or manorash:ad home.
Iced-tor ^ef/rytv r�-1rLa- tfyfl\ II` Vv\y) Date signed(snore*
RSiiESUPON:Origami-CastyAidea,FeSameed Cop -Tanem Page 1 of 2
M CLAIM FOR HOMESTEAD PROPERTY TAX FORM I YEAR
STANDARD/SUPPLEMENTAL DEDUCTION
Sin Form 5473(R15/5.14) HOMO
Presmibed by the Depatrnem of Local Government Finance
INSTRUCTIONS:See reverse side for filing instructions. -
NOTE:Telephone,Social Security,driver's license,state identification and federal identitpuon numbers are wn.5dentia/under IC 6.1.1-12-37.ith
_. `t :. . f
s as CERTIFICATONSTATENIENT, 2,.:.,-1 l -t_ - •4;. •T 4:.• /1''•
I(We) L nr .�ddr
A` ) l' certify that I(we)occupied as my(our)prin.:- •Y/\/y/7
place of residence or am(are)buyin `f a following described real property under contract for which a Homestead Pro perty T ndard
C
���DedduGion is hereby claimed on the• to this application is signed, (date of signature). I O�j
Imo,Own. ❑ Am(are)buying under recorded contract ' (J Qis
/❑ Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation. eye ,
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified persd sit.• .
ID Am '
(are)the shareholder, partner, or member of the entity that owns the property. Cu�U 141>;,;:i
_.
If buying on mrtrad,Fee Simple writs name
Recorders o1.ce where contract is recorded - I Record number I Page
.4W ji+''i a •]a :7= i'EiiP,ROPERTY,DESCRIP.TION; erI—k e-CY:; .`iS—:3 ?_L.'r.'`aL"_
Cou . f Township Tamp d- - .(• .. -:.)
OF 1 I_ o- I'40
Partel amber Legal description
fl 1111
Real popery ❑Amuasy assessed motile home(IC 6-1.1-7)
II any the residential s'JYGae cc the land not exceed:rig one(1)acre that isrzneds'211 alsl'Jonds that iutir'ae C used to produce income,descite the rase and portion
of e! . tazet to produce itcie.
d6 -a-..,6- ao-O- Odd. jC/-0 02
' ,• ;.'.PROPERTY OWNED ELSEWHERE BY CLAIMANT -. -
SSe.Carty.and Twrstup Is claimant vacating a homestead?
. ' ❑ Yes ❑ No
ne o1 claimant f-•
I hereby certify the above statements are true,correct,and complete. ■ /� t/ _ / /P� 1
, -of cornad(muber and street rdy,�::a and ZIP code) Jr Address of ..,ad homesead,,i any(number a atree4 any,Wale,and ZIP code)
'
T �_ / IA . _ Li 6 GC GSA
, ASSESSOR USE ONLY . ASSESSED VALUE I HOMESTEAD VALUE I NON-RESIDENTIAL
•Land not exceeding one(1)acre immediately (1)
surrounding residential Improvements -Other land (2)
Total land(line I plus line 2) (3) , _ - - _ _ - -
Residential Improvements or Dwelling (4) I -- ,
Annually Assessed Mobile l -- '_ -
Manufactured Home Garage (5) I ._ r t ,_ ,-. ` J.TYr
i
Other improvements (6) I'-•Cu --�
Total improvements(line 4 through fine 6) (7) I
Total value (line 7 plus line 7) (0)
I hereby certify the above Is true,correct, (Signature of Aaaessor Date signed('roan'day,year)
and complete.
Verifying action-Signature of?d:tor Date signed(monai day.year)
•
3111" :Z STANDARDDEDUCTIONALLOWANCE. s - ."E--s^+
20 pay 20 Lesser of 60%of the assessed value of the homestead or 545.000
Nolwlths'andug any other provision,the sum of the deductions provided in IC 64.1-12 to a mobile home S
that is not assessed as real properly 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.
1
Signature of Audmor Oats signed(month,day,year)
DISTRIBUTION: Original-County Aod«r,Fie-Samped Cory-Tax{ayer