Homestead_Markwell _ CLAIM FOR HOMESTEAD PROPERTY TAX
-l '^. FORM ir�lrt�
•
: .::� STANDARD/SUPPLEMENTAL DEDUCTION
!'�� Prescribed by Me Department afloat e• .sum Finance [�/�I
NOTE:TCelep/mne, Smarty&Vero kense,slate d .'aio and federal itlerrliiS�m numbers are confietttial under IC 6-1.1-1247.^,V o
/���/,��j CERTIFICATION STATEMENT _ s 018
I(We) !flh ✓ ' - at at Clertify that I(we)aca as w_')pnnagal
place of residence ar am(are)buying the •i• •desalbed real property under contract for which a Hofr et�4' 1:T so• -•e•Deduction is hereby claimed on the date r r application is signed, (date of signature. ) .,Y
❑ own. ❑ Am(are)burng under recorded contract Nrr A.IOITOR
❑ 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 occupy the property under the terms of a qualified personal residence trust
❑ Am(are)the shareholder,partner,or member of the entity that owns the property.
_
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Legal descriptor: i 13 the nrryestorc
Rea prgen ❑annum assessed made home(IC 6-1.1-11
It dthe'addendal saumae a to lad not exceeding one(1)ace flat breerLZa)y aata-tang is used to produce immune dept.are use and mouton
utlred is pohra income
J A3-//- O0- vow. 9,7- 00?/
-' '°-"J Y.-._ . PROPERT.Y.OY/NEDELSFWI ERE 7'S AA'IA7AN177. Itt-yattar:{'Z__°fr
Stan.Candy,and Toarnehip Is claimant vacating a homestead?
❑ Yea ❑ No
Somme of claimant
I hereby certify the above statements are true,correct and complete. , 1344-4/A) a_it ey bkote
Adam d mated(rembvad sbeR erase*and Woad" Acidness Srabd homestead.nary Q ntaandshwl city;S end ZIP cod)
11 59 E, Lt 11u1., 5 ruLu'Y Ia
_ ASSESSOR USE ONLY _ 1.-,. ASSESSED VALUE''v ' HOMESTEs.D VALUE - � NON-R gSIDENTIAL ;:'-`=a
Land not exceeding one(1)acre bimonthly
surroundirg rntdent'elino oeeu�eub (1) ▪ r )-se } .l ::' :
Other land (2) + i -
Total lead(fine 1 plus line 2) (3)
(4) is ...r h?:
Residential improvements or DwellIng 4 t ?
amuagy assessed mobile/ ▪ r.r 9-_
manufach red home Garage (6) ,,Ei.?:.9_^:;-, ...-. _'r`:'
Other improvements (6) c ._ ieTT
Total Improvements(line 4 through line 6) (7)
Total value (line 3 plus line 7) (9)
I hereby certify the above is true,correct `-+a''m°s of Assessor oar signed(nmd4 S+y Wag
and complete.
vatma scion-Siamese dfssftx Dale signed(cones day.lea)
20_pay 20 Lesser of W%of the assessed vase of the homestead or$45.000.
Noh nhstandng any other provision,the sum of the deductions provided in IC 6-1.1-12 to a met&home $
thefts not assessed as coal popery or ID a nnamdadNred hors Mat is not assessed as real pmpetty may
not exceed one-hat OM of the assessed value of the mobile hone or manufactured home.
Sigmas of Audis . Dale signed Moth.day,yee)
0151Rl TON:Original-CC tyAcL'a,I#SarWed Copy-Tagayer
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