Homestead_Nossett ,�� CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
r..14...-.1.,_l y?,_ STANDARD/SUPPLEMENTAL DEDUCTION FORM -
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� Presaibad bYae Department mtnm cwartoev Faunw
INSTRUCTIONS:See feverse side for Arm Frsttucfions. ;!
NOTE Telephone,Social Saaa3X driver's ecense,state bentth n and federal i0entaration numbers are confidante!under IC 61.1-12-37. /
CERTIFICATION SSTTSTEEMENT - r
I(We) Marrs/_% ,II`1.�L._ certify that I(we)occupied as my(our)...
place of residence a am(are)buying the following described real property f er contract for which a Homestead Property,Tax Star 410
Deb•is hereby claimed co the date this application is signed, (date 66 faro ):
�Y,Own. ❑ Am(are)buying under recorded contract $ON .
/❑ Am(are) entitled to occupy as a tenant-stockholder of a cooperative housing corporation. CO0.
❑ Have a beneficial interest in the trust a the right to occupy the property under the terms of a qualified personal residence tn.&
❑ Am(are)the shareholder, partner,or member of the entity that owns the property. 0/TAR
/ T r a m s t l p T
/(JJ enU
nIDa
/ in quegka
atle f y� to is ere Real pcpwty ❑Annadlassessed rnoeia tern(IC 6f.1-])
it oaf resUwdr Muddy land n rea IYJ one ) that r,--
onmrn 31n01 b prole income.deYl®e en me and parjon
came LazedbDodaeimne. C/ Qt
J6- /a?/�floo-D6I/. 2.S,r-eOle
„�-a.77:•- ,752"�:r k -, `IIPROPERTYhOv/NED.ELSEWHERE BY;CCA MIA NTn -' - .ice`-i'F :.N }.•
State,Catty.aal Tworship Is claimant vacating a homestead?
❑/Yes ❑ No
I hm-eby certify the above statements are true,corned,and complete. ihre m -nn�l Adams d covatl(rxarberat valet,city:Ca ,,wdZ/Pm2) el vacated a r end EP cod.)
l,V' HI I E. 50 S art t:.,241 x/7(070 .
I, ,- ASSESSOR USE ONLY , :';_ )• - .ASSESSED VALUE-.:-1 . HOMESTEAD VALUE.-'_I NON_R SIDENTIAL°f` -;(
Land not exceeding Mva� ' - $ 'emmnnGq es)inual nprowements (1) k. _
Other land (2) Xe--._ --. 1tr-r,
Total land(line f plus line 2) (3)
I"Resident)al hnprovemems or Dwelling (4)
�'
annually assessed mobile I
r s - . tf y /ale
manufactured home Garage (5) _ __.,..i..:. ...:AS-ie; .4=„et -'.`..
Other improvements (6) sscs..,,?,_,r_-T S .y '
Total improvement(lure t though free 6) (7)
Toth)value(line 3 plus line 7) (8)
I hereby certify the above is titre,correct, S mASSeuer Oats rasa(em'h dal:year)
and complete.
Vaibig arise-Signore otAUSbr Data 0 nerd Oscan day year)
_ � _ a yL-v:4.- :STANDARDOEDUDnouALLOIIAiICE ._. ' . _ .. ->
20 pay 20 Lesser or U)%of the assessed wive of the homestead or$45,000.
No withstands g any other provision,me sum of the deductions provided In IC 6-1.1-12 to a mobile home S •
that Is not assessed as real property or to a manufactured home(batls not assessed as teal propesH may
not exceed one-ha/(1t4 of the assessed value ovie mobile home or manufactured home.
SiprSae mNiEOr . Data Ogled(nadh dal lair)
cessmaJRON:Orland-Carey Audta.R-Stamped dale-Taaeya
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