Homestead_Young (22) CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
4_ ....7.,i.`4 STANDARD/SUPPLEMENTAL DEDUCTION FORA!
Ws Form 5673(R17/1-1e) HCIO
NmC.md M to Depamr®G or tom:Government Creme
INSTRUCTIONS:See reverse adz for Ping tutrucffons
NOTE Telephone,Soda/Sear*divers ff ense,state identifcadon and federal lden ibcafon numbers are=Mendel mots le 61.1-1247.
CERT!SICATION STATEMENT -
i� i/ •ii
(we) s `i i9_ .l-• -•-p d1ai)? `z• IsEAIPT?RMROR TAXATION
place of residence or am(are)buying me following..:.-. real property !�!�:-• Tvt�� It
i . Pip=_i r tardald
Deduction is hereby calmed m the date this application• skirted, `� g der`-,e.: �•- Iqr ` fcs ¢P[an<e for transfer
❑ Own. ❑ Am(are)burying under recorded contract �� 1] g n _day of -_ -
❑ Am(are) entitled to occupy as a tenant-stockholder of a cooperative housing coroA.
❑ Have a beneficial interest in the trust a the right to occupy the property under the teens of a • - , :h - Auditor
❑ Mn(are)the shareholder, partner,or member of the entity that owns the property- •�:'f •..-,e/r)m.i - Auditor
Cary Township •Twig /tmmsh iJ
Pa amber laps desedpion Is aaAML C-�� •
•
properly ❑Amavy=wend=Mali Mme(IC 5-1.1-n
tam exam of he reddefds drums.or to Iasi not exceeding ere(1)acre that th.medasy su mends that=sure is used to produce Fans,deserts aw use and paten
at to property hp$ed to produce inn
R / — a -Oaj -ao3 oo - /t 37 q O-a gal
:_=". rr'. 5,.:71t, ':PROPERT.OWNED.ELSEWHERE.BY.CIA IMA NT --..?1'.4717' ' -T; • #¢ d•;n
Std,Casa,aid Tomsk Is claimant vacating a homestead?
❑ Yes 0 No
I hereby certify the above statements are hue,correct•and complete. Q f/,
.. ....-a contact(number art sheet city,a ale,end 2/P cob) a vacated h8 y ed save(cry,ea,m Words)
.`a %:. , c
G.- o. A 7 7 0 _ __
_ ,-.1 'ASSESSOR USE ONLY O - _ p ASSESSED VALUE r 1 HOMESTEAD VALUE:i:.:j NO7i NALIVENTIAL
Land not exceeding one(1)acre bmmedietety i p,;-
surroundbagresidentialbnprovements (1) _ .'s s,.v
: j i
Other land (2) -.�z.i-C: .__,x, :_2:!
Total land(line 1 plus tine 21 (3)
O r 'Residential eme or Dwemmp (4) - r s 1:14
annually assessed mobile I dx y manatee/sued home Garage (5) af is , _ -
Other improvement, (6) _,-�A�5�:. .:_.'-°s--_:..,...r:
Total impnu..u,•.nts(line a through line 6) (7)
Total value (line Spits line 7) (8)
I hereby certify the above is true,correct, re anssessor Data signed(maned day,leer)
and complete. •
Verifying action-Signalize Needier Data sgerl pnoal*day.sew)
• _ '. STAIJDARD.DEOUCTIONALLOWANCE.}��.' - u. _. ? -t,
20 ,,,, pay 20 Lesser of a0%of the assessed value of the homestead or$45,000. .w
Nah.VhstaMag any other provision,the sum of the deductions provided in IC 61.1-12 to a noble home $
Matis not assessed as real property or to a manufactured home that is not assessed as real properly may
not exceed one-hal(1/2)one assessed rake of the mobile home or manufactured hone.
C....- c - c A- ice
DISTRIBUTION:Dhy'val-CounyAmax FM9arped Copy-Taxpayer
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