HomeMy WebLinkAboutHomestead_Luttrull --" CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
" "'•- STANDARD/SUPPLEMENTAL DEDUCTION FORM
-� State Form 5473(R1515-1a) HC10
Prescribed by the Depa-.mem of Local Government Finance
INSTRUCTIONS:See reverse side for Wing instructions •
•
NOTE:Telephone,Social Secu ity,driver's license,state rdentdication and federal identification numbers are cnntdengal under) 6- .l- •3 i F� �.
t` ! '" 7 " ' - ....e•CEPjIFICATION STATEMENT -, - { c•",'.c-5' 'xrri(�✓
I(We) C 1 / Of r 1 certify that I(we)occupied q�;�rp�1y���(oaj�r)fnn,,a I
place of residence or am(are)buyi'C e following described real property under contract for which a Homestead Pd6'(iiiy Tic x(01'
Deduction is hereby claimed on the date this application is signed, (date of signature). I(We):
❑ Own. ❑ Am(are)buying under recorded contract
ei
❑ Am (are)entitled to occupy as a tenant-stockholder of a cooperative housing cerpora5on. r s/'n1►tr
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a quaPt#araBleettistryon OR
❑ Am (are)the shareholder, partner, or member of the entity that owns the property.
.
If toying on contact,Fee Simple owners name
Reorders oSce where mind is recorded • I Record number I Page
_,, ? P`�.. •PROPERTY-DESCRIP.TION:s, .+st-3Gs-- .'- - —"Pd
1 Larry Township Taxing dtsic(dry,town,tams*)
Parcel runW Legal desaip:ivr Is the property th q ieation
❑Real property ❑Anmmty assessed node home(IC 6-7t1-7)
If any paten of the resbmtal -ore or the land not exceedig one(1)an that immediately sunoonds that suitors is used to produce income.describe the use and porion
of The popery offered to produce boom.
i G - 1 /1-I a- a°a -0000O9soI2a
. .
' 'PROPERTY OWNED ELSEWHERE BY CLAIMANT - _ . _ . . •
State,Corny,,and Township Is claimant vacating a homestead?
. ' ❑ Yes ❑ No
or imara
'A �j�� Co11
I hereby certify the above sa;emen5 are true,correct,and complete.
1 of mix](renter and Ceet- •state,and ZIP code)r)LAC 113 a hoestead,If any(number and greet.rdy,gatts,and ZIP code)
II ;07 E M, F . . 04c'ia tth V7
-:ASSESSOR USE ONLY J _' .I ;.•_ASSESSED VALUE I HOMESTEAD VALUE. NON-RESIDENTIAL j
• VALUE
Land not exceeding one(I)acre immediately
surrounding residential improvements (1) I
_�
Other Lind (2)
Total land(line 1 plus line 2) (3) _ - - _ _ -_ .I
Residential Improvements or Dwelling (4) _'- _
Annually Assessed Mobile) "-
Manufactured Home Garage (5) s - }.� ,-`a,__
Other Improvements (6) '' t ``
. tees f _.__ -_. __--
Total Improvements(line 4 through line 6) (7)
Total value (line 3 plus line 7) (8)
I hereby certify the above is true,correct, I Signature ofAssessor Date signed(nemh,day,year
and complete.
Verifying=ion-Slants-6 orAudts Date signed(no'dh,day,year)
'�w.•t�STANDARO DEDUCTION'ALLOWANCEN2 �-.=-—._-----__-a-a=_mod
20 pay 20 Lesser of 60%of the assessed vlue of the homestead or$45,000
Notnithsinding any other provision,the urn of the deductions provided in IC 6-1.1-12 to a mobile home $
that is not assessed as real property or manufactured home that is not assessed as real property may
not ex one-half(12)of the arse value of the mobile home or manufactured hone.
Sbnxaae o r j Data signed(mats day,year)
DISTRIBUTION: Origtal-County AUd or.Flt e-&edd Copy-Taxpayer