Homestead_Hunt A ,� CLAIM FOR HOMESTEAD PROPERTY TAX PORS1 YEAR
•
STANDARD!SUPPLEMENTAL DEDUCTION
Stria Form 5473(R1711-16) Hole
Presented by the Oepam.ma a Lay Goverment Femme ' V f
INSTRUCTIONS:See reverse side for fli g alstubare. 1
NOTE:Telephone,Social SeaafX driver's icense,state idenSca5on and hider&identfficafon numbers are confide Mral under IC 5-1.1-12-7.
/1 CERTIFICATION STATEMENT
I(We) A0 re n Nan r certify that I(we)occupied as •plii pat gD
place of residence Gram(are)buying the fotbwirg descnbed real property under contract for which a Homestead Pr1( _J R
Deduction is hereby claimed on the date this app*Cation is signed, (dale of Signature I __��lt��
%Gant.. ❑ Am(are)buying under recorded contract. FEB 2 3 2018
❑ Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation.
❑ Flaw a beneficial interest in the trust a the right to occupy the property under the terms of a qualified personal residence trust.
CI Am(are)the shareholder, partner,or member of the entity that owns the property. f
ady
Panel number Legal Scripts I)me prnpeiy master
Real p tpaty ❑grveady assessed mete.hie(IC 61.1.7)
If any carbon of the reddens aware or the lad not eseu&g one(1)ear that inset/Say duo nth amt auras is used to prods'income,describe the it and praon
of ae property aged lo prim
gam # �3�flogs. o0- 0oS. 534-oat
- r Z - •• at: . - sa t
F. PROPERTY OWNED ELSER'HERE BY CLAIMANT:7.=.
Sxe'Casey,and Tosship Is claimant vacating a homestead?
❑ Yes ❑([No
Swats aravmdMria�T
I hereby certify the above statements are true,coned,and complete. >(
Address daaad(number and slag mend Z/Pamdp Address of
� any abevt. my)
71/0 • ,, - 7/c
dos �,�
ASSESSOR USE ONLY._ _ - I ASSESSED VALUE + `4. HOMESTEAD VALUE 1. L
,.- NON-RESIDENTIA
VALUE
Lend not exceeding one(1)acre Immediately
sunourWhlg residential improvements 0) ss
Censer land (2)
Total land(line 1 plus line 2) (3)
Residential improvements or Dwelling (4) tt-
a
annually assessed mobile/
maml(xhrted borne Garage (5) "} -. � u
Other improvements (6)
Total Improvements(fine•through fine 6) (7)
Total value (line 3 plus ire 7) (S)
I hereby certify the above is true,correct, re of Assesspr bas SOTS(=re,dry,yard
and complete.
Velfybg.aeon-Sense of ASS Due weed(mini,MY.Wad
-.- - - STANDARDDEDUCUONALLOIVANCETt - :e: - c "-f._.
20_pay 20 Lesser of 60%of the assessed Sue of the homestead or$45000.
NoteitstancE g any other provision,the sum of the deductions provided in IC 5-1.1-12 to a mobile home $ •
that is not assessed as real properly or to a manufactured home that Is not assessed as real properlymay
rot exceed one-halt(Vq N(he assessed value of the:mobile home or manufactured home.
Date signed(nn*dry,year)
)2A41Sm; c a ate - tg
DKIRmUnot Original-Cony Ales Re-Stamped Copy-Tamgeya
Page I of 2