Homestead_Wade (2)-
CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
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STANDARD!SUPPLEMENTAL DEDUCTION FORM
rCA4-. saw Fern 5473(RI7 I 1-16) NCI 0
.111111A
Prescribed try the Departmental toad Genevan Finns
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INSTRUCTIONS:See reverse side for grog instruchorra / al .
NOTE Telephone.Social Seco*driver's Item*slate beracafron and federal identificabon numbers are cotadetittal under IC 6-1.1-12-37.
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CERTIFICATION STATEMENT : Eil
. I(We)401.1Wri—..• 40 °,-- .07f4 certify that I(we)occupied as my(our)•Ar•---
place.17AMPYL- jor (are)buying the foLlowing descrthed real property under contract for which a Homestead Property Tax Standaid 2/ 9,
0 •
Ded x ••• is - •,•• claimed on the date this application is signed, (date of signature). I <U1?
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Own. 0 Am(are)buying under recorded contract.
0 Am(are)entitled to°corny as a tenant-stockholder of a cooperative housing corporaticn. 0/8801V
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El Have a beneficial interest in the bust or the right to occupy the property under the terms of a qualified personal residence trufrli
0 Am(are)the shareholder, partner,or member of the entity that owns the property.
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e Tann
lathe • questiort -
C2'41 ketii, Renard/ 0 At=rally assersed meta:lama(IC&I.1-n ..5K 9
.(1)(me thin SUMXIIIIS Mats/maws is used to produce inoccne anate the tat ac podion PN\I\
of the tared to produce Inn
ot../c2,67,..{ad-2cr. c25 097
-,:-.7.-m-..,-.1(----t :ErS,Trff,-;"---"“-'7■-iti5F;Eix-K517MErEistViiirmEniciAna"--77.--v:4&mi.::: '•
a.m.Casty,aid Tom-en Is cLainssmt vacathg a homestead?
0 Teo 0 No
serweeirrnerv
I hereby certify the above statements are true,comet and complete. g' A 4/A,e...,
Address et roan(rens and dset**Sete,end ZIPcoch) Address ,icily(number end Meet al%sate.and ZIPccde)
A c c-e6-1-10&Oa? •
•,...„..,..,....,,..ASSESSOR USE ONLY.- -.a ,7.,_-.Tt-tl.- .ASSESSED VALUE. , 1 HOMESTEAD VALUE •..„„ NON ESIDENTIAL
Land not exceeding one(1)acre immediately :r-'-}--AZ--j:gyr-,,FT---‘6SZM-F,ZT5TrC. r-.4.1-
snot:man residential bnproventents (1)
Other land (7) ;,--„i:.•??,.:V.r:45;2V- -"Mrr.-E.
Total land Obi e 1 plus line 4 (3) .
Residential improvements or DweMng (4) r-k--rrTr-,:::121-'5-At;;A:Terer:T:-. -
annually assessed mobile/ -7;<...:U‘iWV- 4ii.
manufactured home Garage (D) ,.-5-1'..---ae51-4
Other improvements (6) :Zrs*Titt5b4:4,c-ri7M,24-27:Am..ltd.i.
Total improvements(thee through/Me 6) M
Total value(line 3 phs tine?) (8)
Signature of Assessor Date sired tuna 13311 Yes)
I hereby certify the above is true,correct,
and complete.
word othon-Signature of&KW( Date Man nartit MY.Yeas)
.STAWDARD DEDUCTION ALLOWANCE•7 .... ":. . Z-7 .
20 Pal 20 Lasses of 60%of the assessed value tithe homestead or$45,000.
Notwithstanding any other powon,the Sum of the deductions provided In IC 6-1.1-12 to a mobile home $ -
that A not assessed as real property or to a manufactured home Mat is not assessed as real mode*may
not exceed one-haf(1/2)of the assessed yaks of the mobile home or manufactured home.
Signs:sr°or Ando' oats need non daY,Yew)
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CITSISSBUTION:Capin-Carry Auden,Re-Stamped Copy-Itcpaya
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