Homestead_Creasey (2) ,n CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
4.4.1.,•--„v. STANDARD!SUPPLEMENTAL DEDUCTION FORM
�;! Stabs Form 6473(R17/,-16) HC70 .
`�_sj Prescribed by lee Department of Lose Government F,mae
INSTRUCTIONS:See reverse skis Dram et acorns •
NOTE Telephone,Social Security driver's Scene,state ideat5ca5m and federalldertfcaian numbs am maide:Tal under IC 6-1.1-12-37.
. �� - CERTIFICAT,ONSTATE1IENT - ��-,
I(We) ra'l�1Sfi� I ! `. Certify that I(we)! _ -my •1.111',.,:?11;
place of .fir'or am(am)buying the following•—. .-.real property under contract for which a —. ••••-i , c —
Deduction is hereby claimed an the date this application signed, (date of signature). I(We):
O Oval. ❑ Am(are)buying under recorded contract DEC 22 2017
❑ Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation.
❑ Have a beneficial interest in the bust a the right to oowpy the property under the terms of a graphed .♦-j)-• —as env,
❑ Am(are)the shareholder,partner,or member of the entity that owns the property. •7: -.
-_ . _ _
Carey Toemlep wT 7e'Qrald(aly,bow,tanbt4 r
I 1
/. TgaA-C istrisslpmp., ❑Am.aaty assessed made home(IC e1.1.7)
If any porton at the rettlaid axe a to Imsd not ec are(1)acre Cat naneotdy=rounds to Finn is used to Paden Income,des abe to matt and paean
doe Property Lobed Is proem Swam
a' 10- 13 . ac, youo — o DO. 3a 5 - 006
. -.T�u'.... r .�nft :- P,ROP,ERTY.OV✓NED;ELsEwHEREBytcura1ANT T 3 r. „ .^,: .4�-tin,_-J�.
(� 6tste,Carey,and basalt Is clamant vacating a homestead?
v`�r���\J
0 Yes 0 No
stmtseo dtimart
I hereby certify the above statements are true,correct and complete.
?Addmtt dmaad(rxmdevan ec4rCy,safe,and ZlPmda) vacated hams�tlrd any(nmiberand iteet,cky,state,and ZIP code)
.33W4 s (4..t Ind c- okkz4./ Cz ate toccO •
ASSESSOR USE ONLY ASSESS D VALUE[.i HOMESTEAD VALUC...;l NONRESIDENTIAL';.r
m _�.i. . .. r..
Land not exceeding one(1)acre Immediately
surrounding residential improvements (1)
j i
Omer and (2) A dusai , -. flea ._.. _
Total and Uwe 1 plus tae 2) (3)
Residential Improvements or Dwelling (4) i
Of -$ t f,y.�
annually assessed mobile I .ue` �"`
mamrtarbtred hone Garage (5) $ _m_ "5t- rte:
: K T
}Other bnpmvemenb (6) •sat ,rte_`;_=r--_
Total improvements(line 4 through line CO (7)
Total value (line 3 phs line 7) (6)
I hereby certify the above)s true,correct 6+PUate of Assessor Da signe0(=WA dry,yea)
and complete.
Verifying anion-Signature of Andbr Date signed(monA day.year)
u.,'> '.,. r:_'s-STADDA RDDEDUCTION'ALLOWANCE.a‘,.-- s'•.?.vs-_S••^. '.r. '. a �.
20 pay 20 Lesser of 60%of the assessed value of the homestead or$45,000. '
NMxThsta dlrg any other pretties;the sum of the d cbct'ons poeded in IC 6-1.1-12 to a mobile home $
that Is not assessed as real popery or to a manufactured home that is not assessed as real popery may
not exceed one-hal(1t4 of the assessed value of the mobile home or mandadraed home.
Spuese .bib/^; Date signed(modA day,yaw)
A
061Rm(mON:Orip'vs-QazgAU9a,Fie-smwd Copy-Tameye /ay Azt H-5 in
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