HomeMy WebLinkAboutHomestead_Willis (10) ,f^ CLAIM FOR HOMESTEAD PROPERTY TAX FORM
� , STANDARD/SUPPLEMENTAL DEDUCTION
t. ` State Form 54T3(R1n/1-16) HOI0
f#mcmed by ere Department cites Government Fi=lm
INSTRUCTIONS:See reverse side forheng arsmrc6ora -
NOTE Telephone,Social Ses eitc th ens Manse,state n and federalklermbcafron numbers are••. •-*-r) ' 1-12-
--��.. CERTIFICATION STATEMENT '
• I(We) 4iiP tPjnil1IG certify that I(we)occupied as my(era Qlincipal .
place of residence or are)buying the •c.. ' desabed real property under contact far which a fe�,,-,y�-,p�T_
Deduction is hereby•" -_.on the date this application is signed, (date Nature)- I(We):
❑ Own ❑ Am(are)buying wider recorded=tract
❑ Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation.
• — ��.
❑ Have a beneficial interest of the bust or the right to occupy the property under the te=ns ca a qualified 'i17:.- --
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❑ Am(are)the shareholder, partner,or member of the entity that owns the property. GIBSO I s k`% ' ••� -TC R
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Teenage Taxon
arm ( swab w question 0
_I 1 Ig TJI-301 CL- C J Is
pwaq ❑Annually mated moats hone(IC 6-1.14)
tatty parer al to=date!ono tre a rte land nor ematae are(1)ace an y tffi structure is used to Prolce imna,aerate tie m and colon
d the Paperb u46aed m pease craw. •.�..: -''" a PROPERTY.OV/NED ELSEWHEREeV,CLFIhiANT W•_ �-'a. -..77.'-.. ...,_.-',<2'
Sal,Cady,at Toaatia Is claimant vacating a homestead?
❑�Yes ❑ No
11leeby ceNty the above statements are true,=rect.and complete. ' � ��� /il / / .
--ci d Gl{maraa meat ray.spa,and ate)) Adders at lam- G .if en(mater erdsae abr.sate.and zwaw)
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ASSESSOR USE ONLY _ I -,ASSESSED VALUE i ;5 HOMESTEAD.VALUE• .: NON-RESIDENTIAL,, =t
"'VAWE.
Land not exceeding one
Surrounding residential (1) Y
e ' taiis .
Omer land (2) 'ot.. :s, 'f.:Y-: =._4:? -
Taal land(firm 1 plus fine 2) (3) .
n al is or padlmg (4) _ _...' 4c r:
annually assessed mobile
l
manufactured home Garage '
Other improvements (6) ?:s; -@:6'5, 1;"v si : i _-
Total Improvements(line 4 through line 6) (T)
Taal value(line 3 pits line 7) (8)
I hereby certify the above Is true,correct,
Signature o .seas Date signed(nab,�k ewer)
and complete.
Yeayeg action-Sguaee cAud cc Dzm signed(oath day year)
`-- - STANDARD DEDUCTION ALLOWANCE.-Y _ _ - _L4' '-:
20 pay 20 Lesser of 60%of the assessed vie of the homestead a 565,000.
Nom(thstandfgg any otlwprosshn,the sum of the deductions provided in IC 6-1.1-12 to a mobile home $ •
Thal is not arse as real property or to an::ufa red frame thatis not assessed as real property may
not exceed aa(t'4 of the:�- -- of the rmfah lens.w magdacbaed home.
Sipwsecr V ,1111 -/ Dale siged(madR
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