Homestead_Henson (3) w- CLAIM FOR HOMESTEAD PROPERTY TAX FORM
YEAR
C....,„,”. STANDARD/SUPPLEMENTAL DEDUCTION
Ili, Ar 633 Fenn 5473(1/17/1-16) HCIO
Plawibed by le Depelunt of Local Coven ant%Firenze
INSTRUCTIONS See le ere side billing instruction&
NOTE Telephone.Social Seaud%chhe/s beast.state and federal idenflifcaffon numbers we mnislenal under IC 6-1.1-1237.
CERTIFICATION STATEMENT
I(We) ,V_ _ ��__1L�_.i ce�y that I(we)oca I�•• -°t I
pace of residence or am(are)buying the following deserted real properly under contract favor a Honest•.P ..:- :- ."P",1/41,-'.'�,
Deduction is hereby claimed on the date this application is signed, (date ofsgn r I Me):2 017
❑ Own. ❑ Am(are)buying udder recorded contract JUL
❑ Am(are) entitled to soupy as a tenant-stockholder of a cooperative housing corporation.
❑ Have a beneficial interest in the bust or the right to occupy the property under the terms of a qualified ••- •i FF res(den•- • i ;
CI Am(are)the shareholder,partner,or member of the entity that owns the property. -1111,7a
•
- -
Carey TEnts Teem Mast(cdy-tat famlS)
•
Paul amber Legal descrem sthe Plryatyn../.
124 Sr&„Len Q PtPetr ❑Amway- -.cage soon(1c si.1->)
if any portion re the residaeal smmse or Ile land rim egg ore(I)aaa that wands em mare is used to preen Some,matte the use aid petal
Ste PnMaty tared 3 produce income
/2(rf7 — i10 - 3 °a - -1° 5 . a9g- a-1
.--._ _- -
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_ PROPERTY OWNED EL2=:YHERE BY CLFIAIANT y - .. - --.:-;---r ,-
Stn.Canty,and Tomahip Is claimant vacating a homestead?
❑ Teti ❑ No
d dt,w
/I hereby certify the above statements are true,correct,and complete. i CT_ ip a_
fAdmesS ci ad(ambaandtlzt d`b.' a.atlLPmn) Ad]easd�iabdtk,. al� `taster W 4nenc Nee en VPcoS)
XS • e ^' .I:,�. itr.
ASSESSOR USE ONLY - ASSESSED VALUE.,u.I. ,HOMMESTEAO VALUE - , .NON-vESIDENTIAL'Fl,'.
Land not exceeding me(1)acre Immediately. ,21) u `` ;:V,s- 3 '4
announcing residential bnprovanamb x114 4.24: r.
other land -f - .`
Total land(lire I plus line 2) (3)
Residential Improvements or Dweng (4) 1 '".1", r r 3 ,*
gi
ennuagy assessed mobile! _
manufactured home Garage (5) Se f 41::s..•?
al"l'orRIA1,1-tf-02.
c 'x. s:tz Other improvements (6) z f k; -U t c_
Total Improvements(line if through line 6) (7)
Total value (line 3 plus lee 7) (a)
I hereby certify the above is true,correct 'a1Q8 of Assessor si (^ + Yee)
and complete.
Veiyag action-Sinn tae dhGb Data signed(aura day,lead
-"STAIiDARO DEDUCTIOIJ ALLOVIAWC-E�_ �- •'�'
20 pay 20 Lesser of 60%of the assessed value of the homestead or$45.0 W.
No!Csl hang 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 poperfy amp a manufactured home that is not assessed as teal prpertymay
not exceed one-hal(1/2)of the assessed value of the rmbde home or maadasaed home.
Siastaxe of Data sigma(nnt'i day,em)
f A � eye 1,1,4.--4,-
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