HomeMy WebLinkAboutHomestead_Montgomery (3) ., CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
- .:,_ FORM
STANDARD I SUPPLEMENTAL DEDUCTION
._ State Form 5473(R15IS14) HC10
Prescribed by the Department of Local Wvemmen France
INSTRUCTIONS:See reverse side for firing instruct' • - :
NOTE:Telephone,Soc thy,drivers license,s to identification and federal identification numbers are confidential under IC 6-1.1-12-3 - .
--,. r °' ' 'rrCl?RT1FICATION STATEMENT r:'.:- -1-i's-.'t - :-T "!' -f
I(We)annil� laileAr /S/ liif • a that I(we)occupied as my(ourlprindpal
place Vii.ence or am(are)buying• •flowing•ascribed rivinroperty and ntract for 'ch a Homestead Property T 4And rd
Deduction is hereby claimed on the date this application is sig (date of signature). I(We). 18
❑ Own. ❑ Am(are)buying under recorded contract a O ' Ol�
❑ Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation. $ t
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified personal - m� •- :T:;y,,.
❑ Am(are)the shareholder, partner, or member of the entity that owns the property. H ry, '•
"
If buying g on contract Fee Simple owner's name
R_rdets otce where contract is rersted Record number I Page
j 45K LS uPR( ERTY:DESRIp-TIOiI74 ?= ? .:, :7
Township Taxing 47(city nt township) •
IP< d)t-..) 40 CZ-)
Parsl number Legal /� �/ la the•-.•-rty in question:
/r\ �5// /� ri/-eaI progeny ❑ Annually assessed mobile Inns(IC 6-1.1-7)
d paaon of L e residerrial suede a the land not -g one( a that Im�e&a'_m sumo �.that sr err ere a used to produce it ne,dew-Se the�ee and portion 1
w1aed to produce income.
o %'''AY-3t< 700- 00/. d 3.3-CC6
f- 1. ! .,,, :' . _ . PROPERTY OWNED ELSEWHERE BY CLAIMANT a _ - - _ _ __
State.Canty.and Towmsfip Is claimant vacating a homestead?
. ' ❑ Yes ❑ No
Signature of claimant
I hereby certify the above statements are true,correct,and complete. Sand
1 yJ
...( P4dfessal conact(rs and stmt.ray.SS:e.and ZIP cafe) ofvacYedhemestead,if any(umber. •4.. stysta'e.and ycode)
[ c i 1 `a *ODE e) 4461 474.60
7' NON-RESIDENTIAL-:'•
_ ASSESSOR USE ONLY I ASSESSED VALUE , ' HOMESTEAD VALUE'"y -
VALUE
ILand not exceeding one(1)acre Immediately I(1)
surrounding residential Improvements
Other land I(2)
Total land(fine 1 plus fine 2) (3) - - _ _
Residential Improvements or Dwelling (4) _ - p�?•. '�%°• s,
Annually Assessed Mobile I _
Manufactured Home Garage (5) __... _ _ 't• ._
Other Improvements (6)
Total improvements(line 4 through line 6) (7)
Total value (line 3 plus line 7) (a)
Signature of P.»w..a Date signed(month,day.year)
I hereby plete. the above Is true,correct
and complete.
ve y'ug action-Sloane of Pad:tor Date signed 4•x. 't day.year)
T. •§MSTANDARD DEDUCTION ALLOWANCE ,a *7-�r=g '.5�
20 pay 20 Lesser of 60%of the assessed value of the homestead or$45,000
Noltet.hstanding any other provision,the sum of the deductions provided in IC 6-1.1-12 to a mobile home $
that is not assessed as real property or to a manufacured 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.
Sgnetse of A dtor Date signed(norh,day,year)
DISTRIBUTION:Original-Corny A:d a,Fie-Stamped Copy-Taxpayer