HomeMy WebLinkAboutHomestead_Harmon CLAIM FOR HOMESTEAD PROPERTY TAX
YEAR
a"'M STANDARD SUPPLEMENTAL DEDUCTION I FORM
Stare Form 5473(R1 5
/5-14) HC70
Presmbed by the Department of Local Govemmem Finance
INSTRUCTIONS:See reverse side for fang instructions
NOTE Telephone,Soda/Soaarrty,diner's license,state identification and federal identification numbers are confidential under IC 6- . ar v.
. _ :- . . •CERTIFICATION STATEMENT'.p• ' 7.. e • '1,KI a 1-.(I ..,'c.a
I(We) . • - da•/.A--.. ' i i a certify that I(we)oaupted I my ..
place of residence or am(a 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 of sgnature)M14 )IJ 1 2112
❑ Own. ❑ Am(are)buying under recorded contract
❑ 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 ncrupy the property under the terms of a qualified personal -LT: -'i ;mifir;-
❑ Am(are)the shareholder, partner, or member of the entity that owns the property. GIBSON COUNTY •UDITOR
t`
trying on contract.Fee Simple owner's name
'Recorder's oCa where Domaad in recorded Record number Page
? y r - 'u PROPERTY,DESCRIP,TION'. 2pr
Cwa:y - Township Taxing (dry own fams'ip)
Par,a1 number Legal desaipdon Is the property in guesion:
It_ 3i ❑Real property ❑Pmuaey assessed=ale home(IC 6:.1-i)
If any paten of the Iavdertial sauc to or the land not e.xMig one(1)acre that immediately surrounds that structure is used to produce etcorne,describe the use and portion
of the property utilized to produce Income.
d /o -/Y-r' 8 - /003 - 000• / .21 - 007
•-.PROPERTY OWNED ELSEWHERE BY CLAIMANT ••'• - _ • - " _
Stare,County,and Township , Is claimant vacating a homestead?
. - ❑ Yes ❑ No
are of claimant
I hereby certify the above statements are true,correct,and complete. `/�/JW�
\/Address of conaa(number end sceet ofy.sate,and LP rode) I Address of vacated hones ad (number same[ ala.and Pmt)
133 West Dr- Oa kind c IN 47�@b
.t' ASSESSOR USE ONLY '"— i I . . ASSESSED VALUE 'I . iHOMESTEAD VALUE I •i' NON-RESIDENTIAL'
'1• VALUE
Land not exceeding one(1)acre Immediately -..r 5' '-r=-'"1
surrounding residential Improvements (1) . d•sr Lz�i
Other land (2)
Total land(line 1 plus line 2) (3) - - i ____
Residential Improvements or Dwelling (4) I ,i *..- _c`i'_?µ:`.`"v •
Annually Assessed Mobile l I
Manufactured Home Garage (5)
Other improvements (6) I __•-t_iY __ +.�
Total improvements(line 4 through line 6) (7)
Total value (line 3 pits line 7) (8)
I hereby certify the above Is true,correct. Signature of Assessor Dux signed(month.day,year
and complete.
Verifying action-Signature of Aud-tor Date signed(month,day year)
._,5. — '1'.'S r y'T4;P5- 'STANDARDDEDUCTIONALL• ANCE.-1 ya=y-al -_‘--i-- - - i al.20 pay 20 Lesser of 60%of the assessed value of the hortiestead or 545,000
Nonce—intending 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 toe manufactured home that is not assessed as real pmpery may
not exceed one-hall(12)of the assessed value of the mobile home or manufactured home.
Sgaae of Audio( Data signed(cur.day year)
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DISTRIBUTION: Origral-County AUdtr,FHeSamped Copy-Taxpayer