HomeMy WebLinkAboutHomestead_Rice (2) _r, CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
STANDARD/SUPPLEMENTAL DEDUCTION FORM
Sate Fonn 5473(R15/5-14) Local •
Prescribed by the Derarment of Ll Gov Finance ance
INSTRUCTIONS:See reverse side for filing instructions. -
NOTE:Telephone,Social Security,drive/s license,state identification and federal identification numbers am confidential under IC 6-1.1-12-37. '
__ F .---(it-' , _'$ .' ."CERTIFICATION STATEMENT s--i'_ :..'. ''t,'+? '''''''''-±2:2-7.;;•4 .
I(We) 'A' 1) it a certify that I(we)ocalpied as my(our)pn24 al
place of residence or am(are)buying the following described real property under contract for which a Homestead Property Tax Stager*
Deduction is hereby claimed on the date this application is signed, (date of signature). I(We): 26+
.2 Own. ❑ Am(are)buying under recorded contract C,SS'G , ("0/2
❑ Am (are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation. tie a i'
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified personal reside ": r-,T�y,-�
❑ Am(are)the shareholder, partner, or member of the entity that owns the property. •Y
:
It buying on contract Fee Simple owner's name
Recordees office where contract is recorded Record number Page
5 ; :gr FSt- -PROPERTY.DESCRIPTION -'7 „ex=.arASy
County Township Taxing d
( (on', t 'F)
Parcel number Legal desaipoon Is fhe property in quesborr
�t)Real property ❑Annually assessed n obee home(IC 6-1.1-7)
If any portion of the residential s:octte or the land not exceeding one(1)acre that hrimedatly surrounds that sthictore is used to produce income,describe the use and portion
of the property LLamed to produce income.
d (a—ia —X5- 300 00 R . $"/ 3 -0077
_,•iLl 7.: 1 PROPERTY OWNED ELSEWHERE BY CLAIMANT _ r _
Sate,County.and Township Is claimant vacating a homestead?
. . ❑ Yes ❑ No
52fl?tere of clOrart .
I hereby certify the above statements are true,correct,and complete. /,I .---, `�
Y P, n. '4—''\!`F9�1-m1 vf,/
Address of contact(number and sheet,ate,date,and ZIP rode) 1 (L Address of vacated homestead.E any(number end Sree&oty,date,and ZIP code)
X 26) w C r I .S o j . fLEd QJ
ASSESSOR USEONLY '-' _ It ,-'ASSESSEDVALUE' I _HOMESTEAD VALUE I;, 'NON-RESISIDENTIAL?
Land not exceeding one(1)acre Immediately -ry $- yr^)
surrounding residential improvements (1) t -Rsa )s_C—,t'r-
Other land (2) y;
Total land(line I plus line 2) (3)
Residential Improvements or Dwelling (4) -,"&
Annually Assessed Mobilel I �1 l � ' -Ys
Manufactured Home ' e° '-' .1"'"t fiN=
Garage I(5) -±t- r. iT.=+;`w€�"YZ_ Et
.j! ' 'iOther improvements (6)
Total improvements(line 0 through line 6) (7)
Total value (line 3 plus line 7) Of
I hereby certify the above is true,correct, I Signature of Assessor Date signed(month,day year)
and complete.
Ve1ytre action-Signature of Audlor Date signed(month,day,yea,
,s'ey_- , "r;bli pt, E°STANDARU DEDUCTION'ACLOWANCEje; � , y .- `--+ r .mod"7.7b;
20 pay 20 Lesser of 60%of the assessed 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 real property or toe manufactured home that is not assessed as real property may
not exceed one-half(1/2)of the assessed value of the mobile home or manufactured home.
Sig: Au :or ' Date signed(math,day,year) .
DISTRIBUTION: Original-CountyAkfor,Foe-Samped Copy-Taxpayer