HomeMy WebLinkAboutHomestead_Smith (77) CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
h - STANDARD/SUPPLEMENTAL DEDUCTION FORM
- State Foam 5473(R1515.14) HC70
Prescribed by the Depa7neN of Local Goeerrc,ed Fvmnce
INSTRUCTIONS:See reverse side for tiring instmCims
NOTE:Telephone,Social Security,driver's license,state identification and federal identification numbers am con5denaal under IC 6-1.1-12-37.•_ _ :',77-4," �.. _ *CERTIFICATIONSTATEMENT•; - -�]`5 L ' `,: ;,`.
I(We) ''._ v i . "e �I - . . ..icy ft!in., •-tidy that I(we)occupi>•l: y .uv pinch":
place of resid- ce or am(are)buying the following descri•a:real property under contract for which a Homestea• ' •pe d T-;Sta
Deduction is hereby claimed on the date this application is signed, (date of signature). I Iv . - ,. .
❑ Own. Am(are)buying under recorded contract MAY ° 9
❑ Am(are)entitled to occup as a tenant-stockholder of a cooperative housing corporation. G 5 [Qj
❑ Have a beneficial interest in the trust or 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.
' •
'
Vhryingm raaorrfsname "'�^-•�"'^mss
Recorder's o5te where mrcaa is recorded Record number 1 Page
T.f' k-' a'c" z r .'' `ri'-I:-•I`:° =i�'?RROPERiYiDESCRomoN- 'il�."".ii 'k= ; k
County Township I Tau town,tmvnsfS) ._ .. .lot
Parcel number Legal desair s Its thhee,property m quesd c
Baal property ❑Annually assessed mcbee home(IC 5-1.1-7)
e any portion of the residential strC. e m the land not exceed4g ore(1)acre that immediately=rounds that eacoae is used to produce income,describe the use and portion
of the property to ized to produce boccie.
10—/ /S— /Cb?— ctti/ /3-8. °a K
' "^ - - PROPERTY OWNED ELSEWHERE BV CLAIMANT � ;-R ' - - . . .._- ,
Satz,Coady.and Towshp Is claimant vacating a homestead?
❑ Yes ❑ No
Sig ayn
I hereby certify the above statements are true,correct,and complete. -
Andrea of 7mnuses(number a st d-eet,cd)t at and ZIP code)�,.,,7I ,�/1 -J� Address of vs ed homestead.it any(number uM.Oeet•d5y,sate,a d ZIPcde)
8``( 5. Ir1A;v WinceAc_'1j," �T10
,.ASSESSOR ELSE ONLY: '-I •ASSESSED VALUE HOMESTEADVALUE I NON-RESIDENTIAL-
-
VALUE
Land not exceeding one(1)acre immediately I(1) I _�_---.-e__- _:.•_surrounding residential improvements
'>:<->
Other land (2)
Total land(line 1 plus line 2) (3) - _ - - -
Residential improvements or Dwelling 1(4)
Annually Assessed Mobile/
Manufactured Home Garage I(5)
Other Improvements (6) _ 5 '`_:;�•^
Total improvements(line 4 through line 6) (7)
Total value (line 3 plea line 7) 1(8/
I hereby certify the above is true,correct. Signature of Assessor Date signed(march,day,year)
and complete.
V.-:):y aeon-Sgnatne of Add5r Date signed(coon*day.yeas)
rt;;I STANDARD DEDUCTION'AIL'OWANCEwi( I`T-i=_': - --
20 pay 20 Lesser of 60%of the assessed value of the homestead or 545.000
Notwith5andulg any other provision,the sum of the deductions provided in IC 6-1.1-12 toe mobile home $
that is not assessed as real property or toe 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.
S"gns^_•AW:w Dela signed(ron:h,day,year)
7, .w CRS •
DISTRIBUTION:Orgnal-Corm:),A:d'.ar,Fie-Stamped Copy-Tarayer