Homestead_Richie (2) CLAIM FOR HOMESTEAD PROPERTY TAX
itrs „,
YEAR
4,, ,.........•n STANDARD/SUPPLEMENTAL DEDUCTION FORM
Slta Pcnu S4la(R17t 1-16) HOW
Presented ty the Depaerwa of Lora)Goverment France
INSTRUCTIONS See reverse side for Wing instructions. rg
NOTE Telephone,Social Seaafll(dnbers items,,Nate ideMSce5an and federalideal/Mon meshels are conEde,Cml folder :.'.1-T?-3 r
�1�r; s ""/-//�•;EP,i.F! : 11l1on sTATcrAENT ,'
I(N) l l..itt.ra 7/t inrartiv. Zwa-. lei that I tee)occupied as my(our)�Prin�cipa�l
place of residence or am(are)buying the following descnbed real property under contract for which a Homestead Phm4'Ix Sla d
Deduction is hereby claimed on the date this application is signed, (date of signature). I(We):
❑ Own. ❑ Am(are)buying under recorded contract
❑ Am(are) entitled to occupy as a tenant-stockholder of a cooperative housing corporation.
❑ Have a beneficial interest in the trust or the right to omupy the property under the terms of a ousel* -- .- ' 441
usel* 441
l:1 Am(are)the shareholder, partner,or member of the entity that owns the property. w i AL.DI TOR
Towehp Tmey<Istia(ot
ctircraa.cl-�
Percel
0-19 /q'f O�s?-�1Gf�deK?a�.4, Is duo °°�bmill
?(10'7 !� •J/1.t.7ti ll� `' )^,"/}o W Kai P'oPatr ❑Amway assessed metes aroma(JC 6-1.1-n
e any porton of me readertal comae a Pe Land not sweeten one(1)era ma immeantay wails that smtare is used to mars Mods describe bee ate aid anon
of to papery razed to paste Irmo.
r ? . YT T__- .t OPERTY,OVJNED-ELSEtVHERE BYCLAIh7N _ - .:.:
Std•Cary.aid TOwakp Is claimant vacating a homestead?
❑ Yes ❑ No
aaamae M
I hereby certify the above statemads are true,correct,and complete. \^ /1 ../i e
Admen dmded(reenter err/meet city,fete.and ZIPS) Addess attvvarated dharnessed`d .mwmte eat street dtr ca.and ZIP )
1006 S- Cent+ r 5+ . 6rohcLl, IN
�/an
i ASSESSOR USE ONLY i•l 'ASSESSED VALUE': HOLiESTEAO`JALUE . NON-RESIDENTIAL- -
VAyL�UE
Lend not suruund'mp resresidential bn)provements nth` (1) •. '`X y�.c#T 'S ;:?.,
i 4s=c
Other land ,.`'::;.:4=iY,._:..z'4=:::
Total land(lire I plus line 2) (3)
Residential improvements or Dwelling (4) 9-' orb -'
annually assessed mobile 1 i £ a -
manufactured home Garage r - _V c`�
Other nprovements (6) 4 ±� _S 2"4]v
Total Improvements(dim t through line 6) (7)
Total value(tine 3 piss line 7) (8)
I hereby certify the above is true.correct.
Signature of Assessor Dab dpxd(nbrrq day,year)
and complete.
Waled acton-Simcore aAudts Data signed(moult day:yea)
_s =^fQY 1 "STANDARD DEDUCTION ALLOVJANCE[ Cr -
20_pay 20_ Lesser of 60%of the assessed,due of the homestead or$45000.
.-,7. .any other provision,the sum of the deductions provided in IC 6-1.1-12 to a mobile home $
that is • .- -•as reef properly orb a -nufadmed banter&is not assessed as real pmpfy may
roes. .. . . (1/4 a fie amused .3 die mobile • -
f I
Dee 1a7 ma ��
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DISTWerr1ON:Gigird-Caddy,4dla./iaanped Copy-Taxpayer \