Homestead_Wise CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
AcC e .;� FARM
STANDARD/SUPPLEMENTAL DEDUCTION HC10
S'a'le Form 6473(R1711-16)
Prescribed by the()spanner(of Lod Gavartnery Enema
INSTRUCTIONS See reverse side A,Ong imb e:oat
NOTE Telephone,Social Se l:fix divertfcense,stab idenfacason and Federal ider con numbers are confidential under IC 6-1.1-12-37.
CERTIFICATION STATEMENT
• I( ) R le_I-p rot Lai-Coll-6 certify that I(we)occupied as ) D
place of residence a am(are)buying the following desalted real property under contract to which a Homestead Pnop�
Deduction is hereby claimed(>n the date this app icatlon is signed, (date of Signature.
Cr°"m. ❑ A e(are)buying under recorded contract JUL 12 2017
❑ Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation_
❑ Have a beneficial interest in the trust 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.
- , •
•
Dana Township - Tasfg disev(rays fawn lair r)
Pad war Ltd desosi I Is me arty it mmSUr
6j'Real property ❑Annually massed cooW lore(IC 6-1.1-I)
U any corral d the matted drttmre a the land not eadectg ow(1)sae der immerse*wands tat sTamae is used to cotes Yonne,describe he use and anal
of en property Lazed In Pods:boars
a(0- oa -c -ors - 000. s/a- o18
_-_
7' � --PROPERTY OWNED ELSEWHERE BY C LA Ib1AftT�,; i."1<
State Casty,at Township Is claimant vacating a homestead?
❑ Yes ❑ No
Somas a•r..
I hereby certify the above statements are true,correct and complete. A i® `u/h
Adbess d monad(aobrara abet city.&de,and Wade) Addea- .._.._.tgneffiad,d (rvmdvat atd 7IPmrb)
X 70 ; L=Awe S/; E :oli-I ✓`Z I Z IPn) '/7h 0
.-ASSESSOR USE ONLY .. 1- ASSESSED VALUE_. .i HOMESTEAD VALUE.• 11j.NON_ESIIDENTIAL_
Land not surrounding residential enprorsMs (1) '1'-ixT irtZ4t
X T ; ntE Odder band (2)
Total land(fine 1 plus line 2) (3)
Residential Improvements or Dwelling (4) i s `c 1 n
mutually assessed mobile f fi '
manufactured home Garage (5) ... ..
.- _..—,.s.e ._.-._�"
¢ S ';:c Other Improvements (6) r:� i74,3i r
Taal improvement,(lone 4 through line 6) OR
Total value (line 3 pits tine 7) OR
1 hereby certify the above is true,correct. dawssor cab Wined(mgrult day,yea)
and complete.
Veining eaten-Sipmae dilutor Data Surat(node M:year)
- .._-.. —STANDARD DEDUCTION ALLOWANCCC-""- - - - -. 772'---77!":
20 pay 20 Lesser of 60%of the assessed vdue of the homestead a*65.000.
Nohvithstarrfing any other provision,the sum of the deductbns provided in IC 6-1.1-12 to a mobile home $
that is not assessed as real property or a manufactured bane that Is not assessed as real property may
rot ex one-hal(1r4o&Ne valise ofthe mobile home or manufactured home.
ma dace(math,day,teen)
DISTRIDUTUON:Original Cosa AURA,Fie-Slanted Copy-Tam%er
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