HomeMy WebLinkAboutHomestead_Crothers ,^ y CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
4��c.7 STANDARD/SUPPLEMENTAL DEDUCTION
ii:- Sate Farm 5473(R17f 1-16) i HC10
+ , Rasclbed by re Departed or Led Gemmed,Faience •. 1 7
JL/
INSTRUCTIONS See tonne side tor arm imb uc6ons i
NOTE Telephone,Social Secants doter'skense,state Wer5ip5on and federal identacatiort numbers are cor6dn£el under IC• -1 -r '..e �����nn
I(We) " that I(we)occupied as )Tenth
place of residence or am(are)Guying the foaming d real properly under contract for which a Homestead Property Tax Standard
Deduction is hereby calmed on the date this application is signed. (date of slgnaDna) I(WaI 1:
Own ❑ Am(are)buying under recorded contract `)I JI `�4TtfifL"f1i�^',-".'N�ir^^fi[(^�
Am(are) entitled to occupy as a tenant-stockholder of a cooperative housing corporation. GIBBON COUNTY AUDITOR
❑ Have a beneficial interest in the trust or the right to ocapy the properly under the terns of a quabfied personal residence trust
❑ Am(are)the shareholder, partner,or member of the entity that owns the property.
. _
Casa - Township Ta,S,g dy. ma.shyg
Pad rooter
tlLai- 1.bt -1nI-Org 313 D4` R e A e acid dm OC 61.1-n
II any parson deal restlaGel trump a me and not exe gere(I)we Val ktm1e6YSy seraeds that caudate is used a produce done,desate ere m and preen
of ee prepay mind to pore borne.
_,- . PROPERTY,OWNEDELSEV.MERE BY.CL..IhiANT s-
is-- r. - 77",- 772
State.Cady.and Township Is da6nmlt vacating a homestead?
atinarit
❑ AYes ❑ N�p(�J�.(L1A1f/
I hereby certify the above statements are true,correct,and complete. (tn/)� 6 /ter v'' t-�`e
' �J/r+A(�,J o hi•sent rod Zip Q. .1 1A� s merle 1�) S wrote a,d`saveL city.Yafa-eel ZIP cone)
..,. ;_ .--ASSESSOR USE ONLY , ..... i- - ASSESSED VALUE_. _‘ HOMESTEAD VALUE c,l -NO:I:RESIIDENTIAL
Land not I Immediately $ y t.'rF Yaurswndmgg residential mpoveme (t) tr sas_ l i
Omer and R) _._._.... ._-_i,
To and(line 1 plus line 2) (3)
Residential Improvements or Dwelling . r"�... �' x e 1.:
annually assessed mobile/ eg (4) . 1 I �; .
manufactured home Garage (5) 1i x,E_,c7� s7(h.
Other Improvements (6) -€ - r
Total improvements(tee 0 through line 6) (7)
Total value(line 3 pas line 7) DU
I hereby certify the above is toe,correct,
Signature of Assessor Day siaud(arch day,year
and complete.
Verifying action-Signature oA dior Data del(rmnm,der.yea
- sa c-crr. ..4 .. STANDARD DEDUCTIOii ALLOI/ANCE.-•.'; °'T"-ri—'---
20_Pay 20 Lesser of 60%of the assessed due of the homestead or$45.000.
Noaahsantag any other provision,lee sum of the declaims provided in IC 6-1.1-12 to a mobile home 5
thatIs not assessed as real popery or te a manufactured have that is not assessed as leaf property may
not exceed one-hat(UZ)of the assessed vats W the n>obde/once or namdamoM home.
Sgestrespoo f)4).2!or ss Date signed(moth cbe veer)
DSTRIetrtION:CrVb-CaatyAUdia,Fee-Bareed Copy-Todd
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