HomeMy WebLinkAboutHomestead_Willis (5) _C _ CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
t'tc..;,I, STANDARD/SUPPLEMENTAL DEDUCTION FORM
`.+3;, See Fuca S473(Ten/1.16) HC10 I
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Prescribed M de DeGovernment Finance b'vV of Local Government Finance
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INSTRUCTIONS See wens side for hang nsbucbona (n� � ,'
NOTE Telephone,Sodas Seaal divert foense,state ifenSflcabon and federal i enffzafion numbers am orufdential under IC 6-1.1-12-37.act /y
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I(We) ,1 h 7LJr--( certify that I(we)occupied as my(our)principal
place of residence or am(are)buyirAg the following'w'.`,...l'�'.`-,I real property under contract for which a Homestead Property Standard
Deduction is hereby claimed on the date this application is signed, (date of " ature). •
Own. ❑ Am(are)buying under recorded contract "1BSONCOUNTY UOITO
Am(are) entitled to occupy as a tenant-stockholder of a cooperative housing corporation. R
❑ Have a beneficial interest in the tent or the right to occupy the property wider the terms of a qualified personal residence test
❑ Am(are)the shareholder, partner,or member of the entity that owns the property.
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Carey Toenshlp Truro tarot(rdy,lw,((v forts
Paced number �Q 1�„ar� T�� `
w legal descpau Is the property n mesaat
I ( u, - I D D- O o 1 9 1/1 -o a ®Real Recent ❑A n+'9r'assessed noble home(1C 1-1.1-1) `'
O+o at . .t`rs` < M V
of Ms lei edst produce beanie.
Rae lad rceemeellg aelt)maaat saiNd4 aatatmrmeb medbaotaa baanL dsa3a no use and pomdm /
d an pmapertY Mired b Rolm berm
cr;r. SSr y 'ROP.ERTY OWNED.ELSENH ERERY CLAIEIANT -4r . 1-'177
Sane.Carry,a rd Twsuhip pt, p/ Is claimant vacating a homestead
OK ?
?96-7) f ❑ Yes ❑ No
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I hereby certify the above statements are true,erect,and complete. 4 . h. Mt. _
Atone al contact(numbered stint dry.gee.end ZIPOn3) 11 '/ ..._- al vacated ,ifary(matter and sbief,t5ysr,,and ZIPwcb)
spy ' N. 1., , fiytcoo A/ /
v : _ASSESSOR USE ONLY ..2...,I ASSESSED VALUE, .4 HOMESTE O VALUE:'„at._ H VALUENTIAL _
Land not exceeding one(1)acre Immediately -.s -_.
surroundmg residential immprovemanb (1) .1 ,:t�`�;s -
Otherland (2) a r Z. _ .
Total land(she 1 plus line 21 (3)
Residential Improvements or Dwelling (4) i '.` _ .
annually assessed mobile l - .
manufactured hone Garage (5) .-_.s: -_ _ u.. _r_-t t
Other improvements (6) G t; -.a
Total improvements(line 4 through fine 6) (7)
Total value (line 3 pits fine 1) (6)
I hereby certify the above is true,correct. She SASSessa Data signed(novels day,yea)
and complete.
voting apron-Somata oAUtW Data signed(=Mt day,Leal)
eu c - - STANDARD DEDUCTION-ALLOWANCE 'lq -.-i,� . . ._
20 pay 20 Lesser of 60%of the assessed value of the homestead or$45,030.
HolwThsbnmrg any other provision,the seen of the dedcfjons provided N IC 6-1.1-12 to a mobile home $ •
that Is not assessed as real properly orb e manufactured home that is not assessed as real property may
not exceed one-hal(ff4 of the assessed web,of the mobile home or mantdactwed home.
Sgrsexe SAaab , Date sighed(midi,dal(tea)
S�d > � S rrwc %^nA_ (nu l a - H- Li
DISTRIBUTION:aig55-Cony Aver,Fee.4anped Copy-Tmgayer
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