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Homestead_Gullett s _ CLAIM FOR HOMESTEAD PROPERTY TAX YEAR ' y� STANDARD/SUPPLEMENTAL DEDUCTION FORM Sera Form Slid Dept en HC70 / l Resobsd by the DeparhtatdlW4Government Fevre //(,////Y,/�/1) INSTRUCTIONS:See reverse side for firing instructions NOTE:Telephone Soda)Security drhers Uterus.slate Mantas:don and federalldvC&rabon numbers am confidential under IC 6-1.1-12-37. b,,,s{/ I( ) certify that 1(we)oca place of residence a•am(are)buying the following desalted real property under contract far which a Deduction is hereby claimed ca the date this application is signed, (date of ❑ Own. ❑ Am(are)buying under recorded contract ❑ Am(are) entitled to occupy as a tenant-stockholder of a cooperative housing corporation- APR 2 8 2017 ❑ Have a beneficial interest in the treat or the right to occupy the property under the terms of a qualified personal residence trust ❑ Am(areN the shareholder, partner,or member of the entity that owns the property. • i I Township Taxing dstia(dy, Paced master Legal descitm I Is the popery in question t l ¢v3 a ❑Arvy assessed mob%rn(IC 6-1.1-7) If BM pats d to revaahtal s> . "; ,. -.� -zi Sam,Cony,ant Toamteg Is claimant vacating a homestead? ❑ Yes 0 No 1 hereby LsOy the above statements are true,cornea and complete' ®ter. A . Address d ca cl(Sent erect oily,,tee,and 2lPmm) ,!/ Adoess al vacebd hat r_vad,Hshed,city,awe,end soda) 9- iniiiaN - 10,/Dean i`ali. d•Ta]'• 11 dia�tia_R.E�1 Land not exceeding one(1)acre Immediately i- rip m suoundmg residential improvements ( ) r"2-.l „-rix:_ E.v;.Yit f` Other land 1 (2) ,;f ; ¢ Total land(11n1 plus Una 2) (3) 3� :.y - F. r.y_e _: Residential assessed mobile DwaIDnq (4) - .e,x_:_r.:i c - $:__--$' smarty assessed mobile/ manufactured home Garage (5) 7'F^ 33 -�Nf ,in Y• Other improvnent3 (6) --` 4s -?<( r Total Impmvemortb(The 4 through line 6) (7) Total value (line 3 pits line 7) (0) I hereby certif./the above is true,correct Si tPB Of Assessor Dad°tied(°here/%rte PVa) and complete.I Vet action-SVnaLe at Apd'F Done signed(rands day,lee) i nic F_2/14etnSdfr p . nins STANDARD DEDUCTIONAL.LOLVANCE ,,- - n,V411W31411SIGissi 20 pay 20_ Lesser of 60%of the assessed value of the homestead or$45,000. >hg NofaffirxWl any other provision,the sum of the deductions provided to IC 6-1.1-12 to a mobile home S • that Is not assessed as lea)property veto a manufactured hone that is not assessed as mat properly may �Lr�yottteexc�ceeeed onehal(1/2)&the assessed value d the nobae home a,nramdectrred home. 7`/ / ' S / L 6 Y Dab Oared(or*a3f:/mr) ,:ale_ire-C- 'l,_.F�urroeet DISTRaIfiIOIV:Osy"vo'Canty AUSaa,Fas$masd Gyy-Torprry 1 Page l oft 61"c ter. CLAIM FOR HOMESTEAD PROPERTY TAX P�RA1 YEAR -C.,,, STANDARD/SUPPLEMENTAL DEDUCTION CA4 Stta Fam 5473(R11/t-16) HC10 zotoi FF`f' PPrescrbed at to Department or Leal Goverment Frame INSTRUCTIONS:See reverse side braag hstnlllbrm NOTE:Telephone,Social Security driver's ss&cene,e e,state ideNdrabbn and federal ,cambers are confidential u de tial under IC 6-1.1-12-37. I(We) ._} • K& S C\ e v certify that I(we)occupied as my(our)principal described of residence or am(are)buying R_nI Doering desed real property under contract for which a Homestead Property Tax Standard Deduction is hereby claimed on the date is application is signed, (date of signature). I(Vie): Overt ❑ Am(am)drying under rewded housing F[3V.crn(are) entitled to occupy as atenant-stockholder of a cooperative housing corporation. ❑ Have a beneficial interest in the bust a the right to occupy the property under the terms of a qualified personal residence trust ❑ Am(are)the shareholder,partner,or member of the entity that owns the property. . CLAIMANTS INFORMATION Socal Seam ramie cc claimants spore(tat the ergots) Dover's lmre/lant5rs'mn(Other neater or claimers specie(last the*at) lsevg Stele (Nsaarre raked aPpacente rymmdoes na have a auralseoa 'n auueJ II burg on wet,Fee Skmla oafs name Remrdefs obm Wm=tact is recorded JUL 1 b Z019 Retard number Page DaE7S�CRI'PTION Cant Tarthp „Irr c`T-%ili;:,teen,Iternslip) �°'°� GIRSON COUNTY UDITOR Palm) 'legal dexcp� `n b art - Reel Rr4ecy 0 k-easy assessed=tole tyro(IC 6-1.1-7) V any portal d the residential situ re a ea lad not eaeGEg an(1)ma tat iim.oatYly sNadlla C used b produce inane,dale to en an pYaan of to papery dared to pvomboom 26-k3 -ZO-2©0 -coo . 229 - oo it . . PROPERTY OWNED ELSEWHERE 6Y CEAIMANT' _ Ste,Carty sal Tom4ry Is claimant vacating a homestead? ❑ Yes No of claimant I hereby certify the above statements are flue,correct,and comet • AddlQs of=ad(tents-tad meet,My,soda and 2ipYb) 10 , ?w - a VI and dta a'db,ad 2(P0f) X / I ()J _ :. 1' at. Lt_\O n G 1 -ASSESSOR USE ONLY _ -( _ ASSESSED VALUE;-..4.' HOM.ESTEAD\ALUE''.-)1.. re cut NALIDENTIAL _ Land not exceeding one(t)acre immediately (1) • e rr_'t-,S'"" r:t? nd surrouing residentialmb bnproveen x Other land (2) -ay-: ";c_.= >r,1. Tour land(line 1 plus Tine 27 (3) Residential Improvements or Dwelling (4) i _ ;. annually assessed mottle/ ri manufa ctured borne Gauge (5) r. =y --+, Other improvements (6) 5flT<< 3E t+- C,?.}e1 • Total improvement(/true 4 through line 6) (7) Total value (line 3 pica Tine 7) (6) I hereby certify the above is true,correct, �Si a Assessor Data signed Gone der:Year) .-- and complete. NatYi9 acts-Swam rtMai Dana Oiled(meL11 deY.Yea.) ,, ,.. "STAN DARD DEDUCTIOu ALLOWANCE_.'- _ - - _ :�Y.- 20_pay 20 Lesser of 60%of the assessed value of the homestead or$45,000. Nodehstand rg any other provision,the sum of the deduction pvuvid-d in IC 61.1-12 ID a meat/¢home $ Nat is not esse es real property orto a manufacNred home Nat is not assessed as real property may not exceed (f/qass¢slaleat atse of the Or mancdadwed home. C:. kOber oiled gnal-cany1LyAUCtar7s_\FI.-Sa ped COPY--Caterer �at Page 1 of 2