HomeMy WebLinkAboutHomestead_Hall _ CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
�'} - STANDARD I SUPPLEMENTAL DEDUCTION FORM
State Form 5473(R15/5-14) HCI O
Prescribed by the Depa7netd of Local Government Finance
INSTRUCTIONS:See reverse side for filing instructions. •-
NOTE:Telephone,Social Security,driver's kens%state identtication and federal iden5xafion numbers are confidential und- -37. ._ '.!
.. __ - - -^. :CERTIFICATION STATEMENT:' r l t x :71 t 11 YT'QJ
1� -
I(We) Vjr� - �.i !_ ' certify that I(we)o•'• Si my(our)principal
place of resi•ence or am(are)buying the following described real property under contract for which a Homestead Property JabSIQ 7�d
Deduction is hereby claimed on the date this application is signed, (date of siglifik 5(V91)-.`
y .pan. ❑ Am(are)buying under recorded contract
❑ Am (are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation. _I-ii'
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified pe ••_ ,tr •^e'' .`stAU g(TOR
❑ Am (are)the shareholder, partner, or member of the entity that owns the property.
- '+� _ cili
If buytrg on carted.Fee Simple owner's name
Recorder's otos where mcaa a recorded Record number (Page
=elk,? ' . T PROP,ERTY,DESCRIP.TIONrZWASZ %ea.aeVY -Cie 'Ca- -
_ Court,/ Township 1 Tying dm5 (city,t ,township) /
Parcel number legal des{m�p)'+w ///1.,//// ..j/� Is she property it question
`\ r I ad & d /7Lreal RWerty ❑Annually assessed mom a home gc 6-1.1-7)
If any paduon Tr,a ileenal Cu t:ae or the land rot exceeds one(1)acre that's�meds:tly s:... s wtice is used to produce income,describe the use and portico
of the property opaEUre incr.'s.
CI to— i9-3 / 3641 0O-a519 -00 9
PROPERTVOWNED ELSEWHERE BY CLAIMANT'- '.__• • - . . __ _ -
Sale.Cou-ry.and Township Is claimant vacating a homestead?
>°tj Yes 0 N
Signature Ol ddir
I hereby certify the above statements are true,correct,and complete. ( /
Address of cocas(=bet and&me(ay,.Late, ZIPcode) Assess of vacated homestead.I any greet,ray,
(number and eet, Sae,and ZIP Code))
ees
•. -ASSESSOR USE ONLY .( ASSESSED VALUE' • ( HOMESTEAD VALUE' NON-RESIDENTIAL
Land not exceeding one(1)acre immediately I(1)
e3 r
surrounding residential Improvements
Other land (2) ...._
Total land(line 1 plus line 2) (3) - _ - _ _
Residential Improvements or Dwelling (4)
Annually Assessed Mobilel
Manufactured Home Garage (5) _ v_j3@{--
Other improvements (6)
Total improvements(line 4 through line 6) (7)
Total value (line 3 phs line 7) (8)
I hereby certify the above Is true,correct,
Signature of Assessor Des signed(.nth,dry,year)
and complete.
Verifying anion-Signature of AUhor Date signed(meta day,year)
£s-2=• -.ice `° � STSTANDARD DEDUCTION ALLOWANCE ' a.-„ ..cow e.,-4 _
20 pay 20 LPCwr of 60%of the assessed value of the homestead or 545,000
Notwithstanding any other provision,the sum of the deductions provided in IC 6-1A-12 toe mobile home $
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.
2 Dan signed(neat,da/y,—year)
DISTRIBUTION:Original-County Audeor,Fie-Stamped Copy-Taxpayer