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Homestead_Watkins (4) s'sj CLAIM FOR HOMESTEAD PROPERTY TAX -- YEAR ems STANDARD/SUPPLEMENTAL DEDUCTION Fay r�-::3�' Seta Faro sg3(Rn(t-t6) HOW i9/c1 a !� Presentee by are Department or Local Goverment Foam INSTRUCTIONS:See reverse side for Ong bsbuc5ms. NOTE Telephone,Soda[Samai)s divers terse,state idenffiCaSm and federalPleat:Skelton numbers axe mr54ntial under IC 6-1.1-12-37. //���� CERTIFICATION STATEMENT �+ • I(We) ;Ie ._e LnEr yt S+ • certify that l(we)as pied fr 11 asmy(our)•.WI, • place of residence or am(are)buying the following desrnbed real property under contract for wtddl a Homestead Piopeity Tax - •_ • Deduction is hereby daimed on the date this application is signed. (date of signature). I(We): 'POwn. ❑ Am(are)buying under recorded contract MAR 5 - 2018 ❑ Am(are) entitled to occupy as a tenant-stockholder of a cooperative housing corporation ❑ Have a beneficial interest in the trust a the right to oavpy the property wider the terms of a qualified • •- ...residence i .. El Am(are)the shareholder, partner, or member of the entity that owns the property. i ,. — -�✓ y. r '- seedy dstrid Copy,town,Welsh* Ato- O6- ZO - 100 -cb3. 786 -0/ Patti amber legal descpen Is the property F master 20 -l- r• 2 • e -acPddy ❑Annuity assessed mot.hoe(sc 6-1.1-7) N any pabn of the resident strumae or Na in eae[Q¢q a (II ace ea mmadaYy wane DM encore used b aalre etaIsdesate De see aid pram d ere property raged b produce Mane .17 G'(/,P illb :':"' .: 'i=' -i i'v "`sP,ROPERT,Y,OV✓NED ELSRVHERE.BY.CLAIAtAN1 '.- .%'W ' cri•_: -s&?" e Sae,Cerny,aid Tranship Is raiment vacating a homestead? 0 Yes 0 No I hereby certify the above statements are true,correct,and complete. ›C`, if —t Address of read(eater eat sheet d4 e.and ZIP ace) __ __... n-..., 20 LIZ 6 350/� cgNC, t o Sri, ` ' -;ASSESSOR USE ONLY _ I ASSESSED VALUE`_„ Es HOMESTEAD VALUE _+,;I NON:RESIDENTIAL VALUE_- ; u - -p Other land (2) x_ ,.rr..ei -. Total land(line 1 plus fine (3) e ' s {-:*- Residential improvements or Dwelling (4) r - -_ r s .,-..�.: "mutually assessed mobile/ -t, - y 6 n ` manufactured home Garage (6) E Other improvements (6) " <_cr_-: .: ,._. _ _ Total Improvements(line 4 through fine 6) (7) --- Total value(line 3 ph s line 7) (8) ISIIII—. Al and complete. Na above I,true,correct, ; ..., -3.�5) r(!f Vat g moor-Sigare of Andee •-.-dyad(rx.Iadayr' r Ofll• e!_cm c rSTAt:DA RODEDUCTION ALEOWANCEr Za rni 11 _ _,{, 20_pay 20 Lesser of 60%of the assessed value of the homestead or$45,000. ///``` / No)ntrstandi g any other provision,the 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 that is not assessed as real property may 0.A- r 1' me exceed one-hat(Maths assessed value o the rmdrh home or manufactured home. -I11Sr10 CO'U'NTY AUDIT( R Data Meted(watt,day,Yoe° ..41, • et APa- L -.11. a - I�- / 8 otstl®unoN:algal-Cart Audta,FbSmged Copy-Taxpayer Page 1 of 2