HomeMy WebLinkAboutHomestead_Rumble (4) a s CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
/' ..1:'� STANDARD I SUPPLEMENTAL DEDUCTION FORM
_. State Form 5473(R15/5-14) HC1O
Presented by the Department of Loral Government Finance
INSTRUCTIONS:See reverse side for filing instructions. /t j
NOTE:Telephone,Social Security,drivels license,state identification and federal identification numbers am confidential under IC 6-1.1-12-37.
- CERTIFiCATI0N STATEMENT-CtT - - ' rt'':3'' ^�lp ` 1 1
I(We) certify that I(we)occupied as m rrCL)P,y, alj
place of residence or am(are)buying the fo/7g described real property under contract for which a Homestead Property Tax Standard: / 7
`
Deduction is hereby claimed on the date this application is signed, (date of signatu�/ I(We):
y[I Ovm. ❑ Am(are)buying under recorded contract GIB$ ' e/
>g if
(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation. ON CUUNT ,�
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified personal residence si.(/a
❑ Am(are)the shareholder, partner, or member of the entity that owns the property. ITOR
U buying on contract,Fee Simple
owners name
1 RecrdMS o'_'a where contract a recorded Record number Page
r t7s _'ii ttli— :EZEIROPERTY DESCF0..11014:�= t it.-I
Pars .umber L-_-I desai(p_d/on) [' J J Is\JN[e.Ip.t• ,(question
I J/G . 3 - J-/A / `Real.'" . • ' mo%assess d r:wde horns(/C 61.1-7)
d any paaont of the residert al�ucae or the land not exreedrg one(1)�� _, asjJ2rwMS
!bald is used to produce Income,des,-tSe the tee and porton aae
of the popery udced to produce income. •f',J t
09‘- 77 33- coo- 00/. 5"3% -Doi/
PROPERTY OWNED ELSEWHERE BYCL'AIMANT,_.. .1:'•'- . -
53:e,County.and Torras ip Is claimant vacating a homestead?
' ❑ Yes ❑ No
Sgmreo
I hereby certify the above statements are true,correct,and complete. 111 ��yyII (��,�/�/y"�I���
Address of comae(number and street arty,date,and ZIP code) �Ad eEfiom'estead. any(nu an0 steel, ,Vete, ZIPcade)'
' y D • , OAPo
ASSESSOR USE ONLY I ASSESSED VALUE I ' . .
' HOETEAD VALUE'- " NON-RESIDENTIAL' ^ `1
Land not exceeding one(1)acrelmmediately I(t) - h_'
surrounding residential improvements
_ 3
Other land (2)
Total land(line 1 plus line 2) (3) _ __ __
Residential Improvements or Dwelling (4) - '
Annually Assessed Mobile/ �-� . -
Manufactured Home Garage 5 .-
Other improvements I(6)
ITotal improvements(line 4 through line 6) I(7)
Total value (line 3 plus line 7) I(8)
I hereby certify the above is true,correct. Signature of Assessor Date signed(month,day,year)
and complete.
Veey%y action-Signature of Audior Date signed(rmr5,day,year)
'•:7�,-- - i - .1S.STANDARUDEDUCTION'ALLOWANCE —Grit'-_ .3.�``a•:�A- ;v
20 pay 20 Lesser of 60%of the assessed vaue 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 real property or to a 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.
Signature of Atdtor Data signed(month.day,year)
DISTRIBUTION:Orghal-Co_r y Audtor,Fie-Samped Copy-Taxpayer