Homestead_Meny CLAIM FOR HOMESTEAD PROPERTY TAX yrpR
,• STANDARD/SUPPLEMENTAL DEDUCTION FORM
�' � SRbFmn5aT3(R,7r,-,6) Hcio
W Pressed:N'the Department of load Goverment Fiwte i
INSTRUCTIONS See/evens at kw firing instructions.
NOTE Tekphare,Sodas Serif(%divert!tense,shah afenZCaDa1 and federalktrGACa5on melbas are confidential • •--i 6-1.'
I r CERTIFICATION STATEMENT
I Me) a! !na'►7,ne .7/!I L......_, v that I(we)occupied UR,(...i...WI
place of residence or am(are)buying the it. I..descnbed real property under•! .... for which a Homestead Property Tax Standard
Deduction is hereby claimed on the date this application is signed. (date of sign I(yye:
❑ Own. ❑ Am(are)buying under recorded contract `) llls�, .
❑ Am(are) entitled to occupy as a tenant-stockholder of a cooperative housing corporation GIBBON COUNT'( AUC ITOR
❑ Have a beneficial interest in the trust or the right to olxxgly the property under the terms of a qualified personal residence tnW.
❑ Am(are)the shareholder, partner,or member of the entity that owns the property.
- . -
Casby Township Tang dross(rdy.town ue*aa
.
Pe natter !egad destepb:n Ile a Proverb in question
ed
❑Red property ❑Aamay assessed noble tae(PC 6.1.1-7)
ham portion of ee reetlraia mature athe land not=medic one(1)arse RatimmbEely suntan that el=se Is used to prodm Income.desate ae use and scram
of roe property riled to prom Imam.
1( — I1—o1- 4o3 -wO. `1 (93-oat,
Sr" _ '3 ROPERTY,OWNED ELS!.'1ThEREBY CCtTMA6'T "-: 7Z-7 Tr.-1Stye:;,'-°;{
gee,Caruy,all Torisky Is claimant vacating a homestead?
/ // ❑ Yes ❑ No
d�/eI hereby certify the above statements are true.correct,and complete.
••.- d (amesand acid dq:sera endzrPCOatr) }-: ._�ervaaLM iany -ads/nsa 084 'ass,and ZIP coda)
. 3v/ N/ pt// s / r.. . r . _•- ASSESSOR USE ONLY ....-•:,. I ASSESSED VALUE.1'„�r MOMESTEAD VALUE'- ':II _NOtj'RESIIDENTIAL;-.he•
Land not exceeding one(1)sera immediately K �s Vt =tit :�i,-�
surrounding residential improvements (1) 2 xI v -^ 'I a-,
5
'Other land (2) s : l" ii
Total land(line 1 plus line 2) (3)
Residential improvements or Dsv;iiing (4) ':%a`'2-161ec `'+° `r!n.:,W'�:
annually assessed mobile/ t• 'Y' i -
manufacturedhome Garage (5) ;�; '( ..?rot:
S.. r:n..._..
Other improvements (6) ..s -. ,aJ.,s_. .. ,--'.�°:i ' r
Total improvements(lie 4 through line 6) CO
Total value (line 3 pea fine 7) (8)
I hereby certify the above is true,correct, °;c/Assessa Dab dosed 61111e4 dmt yet)
and complete.
Vegytq non-SNeame o/mitr Dm died(marls 6311 7660
^' r`,aE- : ' ."6 STAI:DARDDEDUCTIOUALLOVIANCE•a5C. -+,.' , e
20 pay 20 Lesser of BO%of the assessed vdue of the homestead or$45,000.
NoMdhsmalrg any oterprovSM,the sun of the deductions provided in IC 6-1.1-12 to a mobile home $
that Is not assessed as real properly wed a manufactured hide that is not assessed as real property may
not exceed (I/2)of the a value of the rmbae home or manufactured home.
Seaman d (morla !,e0
D61RIBUnON:Original-Casey Copy-Taapeyer
' Pagel oft
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