HomeMy WebLinkAboutHomestead_Wilkerson"'" CLAIM POR HOMESTEAD PROPERTY TAX
; _ � STANDARD / SUPPLEMENTAL DEDUCTION
State Fartn 5473 (R72 / fi-09)
�O = P2scn6ed Oy the Depariment of Loml Govemment Finarxe
INRTRI ICTI(1NS Snn m�mron cidn /nr fiii.v, fner..,��;n.,�
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� �e) certity iha[ I (we) ��IA9e�in*�1'�Q�iPal
place of residence or am (are) buying Ihe following described real pmperty tor which a Homestead Properly Tax Standard Deduclion is hereby daimed
under conVact on the date this application is filetl, (date o/filing):
I e) own ❑ Am (are) buying under recorded conVact
Am (are) entitled to occupy as a tenant-stockholder of a cooperalive housing corporetion
� Have a beneficial interest in �he wst or the right to occupy the pmperty under the terms of a qualified personal residence Wst
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Name of tla"imant (legal name) /y r0 / ' V
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Sodal
Sot1a1 Securiry numbe� af tlaimant's spouu (1as15ve digits) Drivers license / ItlenGfintion / Other number Issuing State
ot daimanYs spouse (Wst five dgils)
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�� buYVig wi mntra0. Fee Simple awnefs fame
Remrdefs o7re where mnVad is remrdeE � 1 Rerord number Page
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Caunry Township 1 '�j,
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Parcel number Legal deuliption '':
-( -Z, -,�j�j G . 3 -Oa �MnuaVyassessedmohilehome(IC6-f.f-n
If any partion of ihe resitlential swcWre or Ihe lantl not exceeding one (1) aue Ihat immen '1 co proCUce income, Oescnbe 1he use anE porUOn
Iof the property utif¢ed to pmduca inmme. I I
. . � • • • � :
Caumy TovmShiP Cai Townsivp
I hereby certiry ihe above statements are we, corteu and complete. s�qXn�re r aaQ imant/� �
/ \ LD,iL.BY.
3� (J graMSLee(dll: n1e•O OP�� . � V +/��f/�
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su oundn res(dential m�r�o ementsdiauty (�� � r=���i��,;4k }f �'S`�,��'���
: "3 �r` _ z::e+aE...
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Olher lantl (2) � �,�;;y s �:
Total land (fine 1 plus line 1) (3)
"�;+t^ �m'tl'-.s�` > .I,.ai. �w
ResidenlialimpmvementsorMnualty �Iling (4) z',�-��-a:i�E`2,34y�i"ai'�.r�x
Aurssetl Mobile I Manufactured Hwne Garz e � r���;�` #: '.�`e�; rr'� �� �'`�?-
8 is) _..-��.:sr_ei_�eti.'`^.'+-0e`y'.,�,�;1`.v;y,�c.
.��i�:='.�%�5y�s�� "-
O�herimprovements (6) ,,,,, sF�:+.-;�u.;�� �
Total Improvemenb (line s through line � (7)
7otal value (line 9 p6c line 7� (8) .
I hereby certify the above is true, cortect, Signature otnssessar Date signea (monN, day, year)
and cample[e.
Veifying acfion - S9naN2 o(lwAitor Date s9ned (monfh, dsY. Y��
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20 pay 20 Lesser of 60% of Ihe assessed value of Ihe homestead or $45.000
AbRViNSlarMirg any otherpmvision, !he sum of Ne deducfbns provided in IC 6-1. f-72 to a mo6➢e fwme fhat /s g
rpt assessed as real property or to a menulaflured hane ihef is rot assessed as real pmperry maY �f erceed
ono-haH (1R) W Ne asusseC rdlue o/ fhe mobde Mrtre or menNaUUred home.
Signature of hMitar Date signeE (monlh, EaY. Y�A