Homestead_Neufelder (7) A.,, i CLAIM FOR HOMESTEAD PROPERTY TAX — YEAR
ar '&: STANDARD I SUPPLEMENTAL DEDUCTION FORM
Sate Form 5473(R15/`5-14) HC10 .
Plesoibed by the Department of Loral Govermorent Finance
INSTRUCTIONS:See reverse side((prang instructions - 1•
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NOTE:Telephone,So Security,drivers license,state identification and federal identification numbers are confidential under I
ael . 1.1- - .
'nv ",r,,• ' ,-,a ti " 'CERTIFICARON ST.%TEMENtp' - " -
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Uwe) u.j. ?1 ,II P.1.,/,1 sJ G f7`nlj1 i fir, that l(we)oaarpied as r d j! L
place of residence or am(are)buying the following described real property and j contract for'for n 'eh a Homestead Property Tax Standard
Deduction is hereby claimed on the date this application is signed, (data of signatu: I(We):
❑ Own. ❑ Am(are)buying under recorded contract v'm1�al
❑ Am (are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation. GIBSON COUNTY A DITOR
❑ Have a beneficial interest in the trust or 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 owns the property.
'
.,:.
IS buying on convect,Fee Simple owner's name -
Recorder's cam where contract b rec ded Record number I Page
■ $; :Trim!a' }}_` . 1- PROPERTY;DESCRIP,TION a Re '>`'�--'L`"ffis
•I Twins* Taxing C6rid(071... •
I,1 i/1,1 �
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•(,)�p •-rumiba Legal description Is m question
l ,av-1Q-P9 V/ O,% a- _ I proWty ❑Annually assessed ruble borne(IC 61.1-?)
'
If any portion of the residemal moos or the act not exoe g me(1)ace that"un edia.Ny emoundss stnflnre is used to produce theme.describe the use arid podia 1
of the property Lazed to produce income.
_ , _ "- _ PROPERT,Y_OWNED ELSEWHERE BY,CLAIMANT _ ' .;1'-, -,,,
Sax Candy,and Township Is claimant vacating a homestead?
. ' ❑ Yes ❑ No
I hereby certify the above statements are true,correct,and complete. I>1>�:p. a / A ///, -/ / /
Amdr¢as d contact(number and sleet ray,Sara,and LP ate) Address of vacated tomeseadd,,)d aryy1(none err arandl•swsweetT✓y,5are.an LP coda)
foSO G - 0 1-. i 9�
ASSESSOR USE ONLY • ASSESSED VALUE '�I HOMESTEAD VALUE '.I - NON-RESIDENTIAL
•
-VALUE
Land not exceeding one(1)ats¢Immediately (i)
surrounding residential Improvements
Other land (2)
Total and(line 1 plus line 2) (3) — _
Residential Improvements or . (4) cif�_•Pn
Annually Assessed Mobile!
Manufactured Home Garage (5) • y._ ?.. __._ ..
Other improvements (6)
;i
Tote!improvements(line 4 through line 6) (7)
Toal value (line 3 pits line 7) (5)
I hereby certify the above!s true,correct, Signature o1A lessor Date signed(month,day,year)
and complete.
I Veifying action-Signature ofA#xr Date signed W '/+daY.year)
°O 'i2Ingra _12.STANDARD DEDUCTION ALCOWANCEr'r—°-a--y'�_-.a Thct`
20 pay 20 Lesser of 60%of the aseyswd value of the homestead or 545,000
Notwthstanding any other provision.the sum of the deduoions provided in IC 6-1.1-12 to a mobile home 5
that is assessed as real property or to a manufactured home that is not assessed as real property may•
not ex P. •ne-half(12)of the arse -_•value of the mobile home or manufactured home.
d /•`a / / Dee signed(month.day,ph
DISTRIBUTION:Original-Casty a•r-nr,FieSamped C •- - .