HomeMy WebLinkAboutHomestead_Schwartzlose (5) 3; CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
r. '. STANDARD/SUPPLEMENTAL DEDUCTION FORM
See Pam 5473(R17 II-16) HC70
Resorted by the Dgaanae at Loral Goverment Riwice
INSTRUCTIONS:See reverse side hsrLBnd alstrucbms.
NOTE:Telephone,Soda)Sec*at c driver's license,stale idene5=5wr and federal ltlertli&ation numbers are confidential under IC 6-1.1-12-37.
CERT, ICC A11ON STATEMENT
I(We) r' g..� 1 .. . . A ;"/I4 L.. r I J.d1.{:.i that I(we)occupied as my(our)principal
place of residence a- t t )... - s the forlowing descnbed real property •_• • .-• for which a Homestead Property Tax Standard
Deducion is hereby• -•on the date this appra'uon is signed, (date of signature). I(We):
❑ Own. ❑ Am(am)buying under recorded contract
❑ Am(are) entitled to occupy as a tenant-stockholder of a cooperative housing corporation.
❑ Have a beneficial interest in the bust a the tight 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.
' - -
. ''' -
Cant
Perrelrumba- Is to now in sperm 'f7f
❑Redaryely ❑Ama lBuir A)nE (PtIAV /ITOR
It any paten Oft reaEaWal aware or to land rot eatads°one(1)sae get knmeefitely strands that swrmxe is MS to produce mono desato he use and pram
d ere property utrzed to produce Mane.
% ... 04-a (,- 300 - coa•citrii-Otif
4;7i ._ _ _. PROPERTYOW,l'ED ELSE'NHERE 6Y:CCAIh1ANTS�.?.[ - :_i
sae.Cant.ad Township Is de:mant vacating a farmstead?
❑ Yes ❑ No
Or.
I hereby certdy tte above statements are tore,correct,and complete. -
pa, _ Li_ a _ �_41�J1r s _I
J ASSESSOR USE ONLY __ 1 .ASSESSED VALUE_: 1 4 HOMESTEAD VALUE I HON RESIDENTIAL }': `
r VALUE
(1) .-s1-1ff-..-- � F rte'
�1i :i
Other land R) j' r z --c-s
Total land(line 1 plus fine 2) (3)
Residential ImpTovements Or Dwelling (4) is t, ,..>�>z
annually assessed mobile/ - - _ ; �`'
manufactured home Garage (5) —" ~ -t-'.T'.
Other improvements (6) 4,L aS --
L..-p T-tai .r_..,r.... -,
Total Improvements(lined through line 6)) (7)
Total value (The 3 plats line 7) (3)
I hereby certify the above is true,correct. Sigmas°of Au-0."-or DM surd(i2nt dm yea)
and complete.
veifyeg soon-Signature ofAMear D signer((ma day Year)
-�..��.�..-.•P..- - _ __—-r-- -f'Tm.,.. ,s..'3
> � -% - .. � -"STANDARD DEOUCiIOiJ ALLOYJAfJCE.':__ > - -:,; :, - -. ;r - .
20 pay 20 lesser of at%ofthe assessed vdue of the homestead or MS,000. '
Nolwithsbm7ag any oterpmNSion,the sum of the deduce=prided in IC 6-1.1-12 to a=brie home f
that is not assessed as real properly or to a manufactured home that is not assessed as real property may
not exceed L. al(7/2)of the assessed , .of the mobile home or manufactured home.
Well I ICEMEN
IxSTR®lrmON:CrUIrel-CaflyAndaa,-- '--'- ,...Copt-Ta9aw
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