HomeMy WebLinkAboutHomestead_Tooley (2) CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
4 �.; STANDARD/SUPPLEMENTAL DEDUCTION FORM III
Slate Fain sari(81711-le) HC70
Presclbed by the Department or Lord Government Finar.
INSTRUCTIONS:See sown.side twang nsfixfors. ,.
NOTE Ted Social Seaat(X&Vets icence,state idenff5cabon and federalidestbcalmn numbers are mraSdetal under IC 6-1.1-12.77.
����� ��rr CERTIFICATION STATEMENT
I(We) -tt 7i � t&SLAl j Gsi & ID ii _ �.. I(we)occupied as my(our)papal
• place of residence or am(am)• •the 1o00er J•esaibed real property under contract for which a Homestead P Tax Standard
Deduction is.hereby claimed on •-date this-••i .!•• is signed, (date of sign
D own ❑ Am(are)buying under recorded contract. GIBSON COUNTY AUDITOR
❑ Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation.
❑ Have a beneficial interest in the lost 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.
' ,
Towrsbp
Pan maw Legal etotm Is eene ty i question(9 - /4--6-"Xi no•51Si-ob 7 4Ry Prrpedy
❑Ames%assessed .. IVm(IC 61.1-7)
Italy paean of the resMate sbucose at.Land not meeting one(1)and eat mmedateysamuds eet Mxrae Is used to proste Income desa0e the use and portico
d the propnly rifts to prod.intone.
f' c ._..•" .. ATITCP,ERTYOWN-ED Ebs ELVHEREBY,CCAIWANT ':: t.?' -� "-. .iady,_'
San.Carry,and Toaahp - Is claimant vacating a homestead?
❑ Yes ❑ No
I hereby certify the above statements are true,correct,and complete. • ∎
• % a 1 1 t
seeress at eaiad(mrmeaandsox(caseate,and ZIP code) Addresadsaobd - )...�..,4aiy _ •soast,ray.sate.ere ZlPmb)
1e r r /N96,
'ASSESSOR USE ONLY • I CASSESSED VALUE_.= t HOMESTEAD VALUE', NOt:-RESIDE\TIAL
Lodi .�VALUE
u ornery
surrounding residential nprovmems (1) IT 3't
Other land (2) 3 •.M. . ..
Total land Ube 1 plus One 2) (3)
-• --k-? ti;:T T:`rr
}i R gal nprovements a OwegIng (4) . 4-sr^ =x-s =;r'-(fi
annually assessed mobile I - es -i-manufacturedhome Garage (0) - .3r ^a Y6
Other
mpro improvements (7) X-?�x�'t#;_�:-,e;:,��$ E D
Total inpmveinerds(rirmethraglr line 6) (1I 1
Total value (ltire 3 pas fine 7) (a)
I hereby certify the above is true,coned, Sig.aae nfnssesw pap aysl{moary/ fora)
and complete. JUl sat Lult
Verifying action-Sanatre of Aultnr Data signal(na-fe day,year)
' , L ea e!
-....7.o.... >. _ '-STANDARD DEDUCTION ALLOWANCE.`-" .i,, ie r411-151. (�+�+ ;`__
20 pay 20 1 Lesser of 6076 of the assessed vane of the homestead a$45,000. • s • il s
NoMehsfanof any other provision,the sum of the deductions provided in IC 6-1.1-12 to innate home S
that is not as real property Or to a manufactured home that is not assessed as real pmpety may
rot exceed' (I/2)of the assessed value of the mobile hone Or man/ardred home.
One dated tank�/1� /I — 0')03-17
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