HomeMy WebLinkAboutHomestead_Nelson Alit., CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
STANDARD I SUPPLEMENTAL DEDUCTION HOLD
Sate Fare 54]3(R15/5-14)
Presented by the Depaitnent of Local Government Finance
INSTRUCTIONS:See reverse side for tiling instructions.
NOTE Telephone, ; "al Security,drivers license,state identification end federal identification numbers are confidential under IC 6-1.1-12-37.
- -�r -'CERTIFICATION STATEMENT r ^? _ _ -
I(We) Ilr • • / _ -�_ certify that I(we)..�.. ied:,1=s (our)l "..'..j
place of residence or am(are)buying the following described real property under contract for which a Hoed=?--d s...:.`. . .....a4.1'h
Deduction is hereby claimed on the date this application is signed, - (date of signature). I(We):
❑ Own. ❑ Am(are)buying under recorded contract DEC 30 2016
❑ 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 terms of a qualified pers1 al residence trust .
❑ Am (are)the shareholder, partner, or member of the entity that owns the property. 4 •j
_ �1'._.�i/!7711.
--..._..�_. _
If byte on contact Fee Simple owner's name
Recorder's ofce where contract 5 recorded Record number I Page
'e€• :14._kri;-- �t�*ce- Ads',gi PROPERTYiDESCRIRTIONr:t Ig_vc'o?sg?'-`-e-=wn'.s-'s.. ' ,-...WW- ., 3
Coady Township Taxing or,,loam,township)
Parcel number Legal desaip' C a SA-L Is the property i,ques'sn
Pr aE NE a 8-3- 9 ❑Rem Konero ❑amwey assessed mode home(IC et.r-n
e any porton of the residental sr,x ure or the land not exceeding one(1)acre that immediately surrounds that structure is used to produce income,describe the use and portion
of the property hrdbed to podus ihmne.
a6- ao - nn - ADO - coo . 6 /3 _0o /
• •, _ PROPERTY OWNED ELSEWHERE BY CLAIMANT,- _ .. _ _
Sara Couty.and Township Is claimant vacating a homestead?
. - ❑ Yes ❑I No�/7, ,�
dainty /t� -CKN-t2%
I hereby certify the above statements are true,correct,and complete. vC /J�J �-CI
KAddress ofmnx(number and but city,ripe.and ZIP-..-) Adis-essofva(rated�tho rcstead,dsoy(numb.'and street coy,rase.and ZIPwde)
ASSESSOR USE ONLY.. , ' }i ASSESSED VALUE :- ,I HOMESTEAD VALUE I NON VALIDEMwL
Land not exceeding one(1)acre Immediately --- —
surrounding residential Improvements (1) _r +?-i.,._^.r- .
Other land (2)
Total land(line I plus line 2) (3) _ __
Residential Improvements or Dwelling (4) I _3.,y � _-�•
Annually Assessed Mobile l
M I * �^,,._ _ -•anufacbrred Home Garage (5) i
Other Improvements (6) o
Total improvements(line 4 through line 6) (7)
Total value (line 3 pits line 7) (6)
I hereby certify the above Is true,correct, I Signature of Assessor Date signed(month,day,year)
and complete.
Verifying aeon-Signature ofAud-tor Date signed(ruea day,year)
ff^ '`wsrT _-�. '_ - STANDARD DEDUCTION'ALLOWANCE . aNS
20 pay 20 Lesser of 60%of the as.ecsed value of the homestead or$45,000
Notwithstanding any other provision,the sum of the deductions provided in IC 6-1.1-12 to a mobile home S
that is not assessed as mar property or to a manufactured home that is not assessed as real property may
not exceed once--haallf(I/2)of of the assessed value of the mobile home or manufactured hone.
Sgnabm de'��a�i7 l.C�V K/ rr' 'n' J / arc. Dos signed(rnmtl QeY.leer)
DISTRIBUTION: Origial-CoinyAudisr,FeeSampedCopy-TahpayerG ' o —