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HomeMy WebLinkAboutHomestead_Weber (12) 'CLAIM FOR HOMESTEAD PROPERTY TAX YEAR fral- 'STANDARD I SUPPLEMENTAL DEDUCTION FORM ' State Form 5473(R15/5.14) HC10 Presaibed by the Department of Local Gorernnent Finance INSTRUCTIONS:See reverse side for filing instnlcliMS NOTE:Telephone,Social Security,drivers license,state identification and federal identification numbers are confidential under IC• -1 -37. Ji..'..- ^' 7 CERTIFICATIONSTATEMENT` 'r's' -r" ($$3 II fi- .-.f• �''�•I(We) I� ,,.. 'mss-1"n certify that I(we)occupl_: .s • o • •i•.I place of r-idence or am(are)buying the following described real property under contract for which a Homestead Property Tax Standard Deduction is hereby claimed on the date this application is signed, (date ofsgnaturA) 'W ❑ Own. ( ❑ Am(are)buying under recorded contract +P ` S 20 r ❑ Am (are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation. ❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified persona sidence . ❑ Am (a ie)the shareholder, partner, or member of the entity that owns the property. U buyL"g on m:trdct Fee Sinple owxfs name Recorders o5m Mire contract is remded Record number (Page R'-tr s >- t'i2�c'-.4' "-`;lT.4:a P.ROPERTY,,DESCRIP,TION- •r- j°r.,{;:ir''°.s rat.---- Curry Township Tarring district(city,town,township) 71 acA-6-a-r-a—cit- Parcel number Legal desvipton 55/ the property in question: Lde,,, IS. El Real property ❑ Amuany assessed rmbae home(IC 61.1-7) It any portion of the residential structure or the land not Ceedig toe(1)acre thatimmediately srmounds that athier re is used to produce income,describe the use and pork.% of the propeny tatted to produce scene. CZ-1 94' 3/ 'SOI 000. yil A - Oa , % - . PROPERTY OWNED ELSEWHERE BY CLAIMANT - __ _ _ , Sate.Casey.and Tip Is claimant vacating a homestead? ❑ Yes ❑ No x �Lo� I hereby certify the above statements are true,correct,and complete. 1l Aides of mnad(nrmrber and street,city,state,and ZIP code) - -of sated _.. C. (number and street oil-snide,and ZIP code) !b . • - -, .2 • Qu.b a -al • II ASSESSOR USE ONLY - I • .ASSESSED VALUE I-_ HOMESTEAD VALUE' ,I ••NON-RB UENTWL .. • Land not exceeding one(1)acre Immediately I(1) - I - surrounding residential Improvements Other land (2) ITotal land(line 1 plus line 2) (3) _ - I _ __- • Residential Improvements or • OweMng (4) I - - -y-- -'- Annually Assessed Mobile/ �' -"' - - _• - Manufactured Home Garage (5) I _ _- r °-'�.• Other improvements (6) I ='1 'x Total improvements(line 4 through line 6) (7) Total value (line 3 plus line 7) (B) I hereby certify the above Is true,correct, I Signature of Assessor Date signed(month,day,year) and complete. Verifying action-Signature of Adtor Date signed(month,day.year) -°"y-' :`-k. "1,:pre c ctrAa 5TANDARO DEDUCTIONALL'OWANCE .r�'�='r' '-=' e 20 pay 20 I eesar of 60%of the assessed value of the homestead or$45,000 NoM4thstanding 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. Sgraoce of Austor / Data signed(tut\dry,year) DISTRIBUTION: � -