HomeMy WebLinkAboutHomestead_Byrns (9) C. CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
r t l STANDARD/SUPPLEMENTAL DEDUCTION FORM
HC10
State Farm 5073 9(17/1-1%
Ftaaibad by the OamNnaa of Local Government Flan
WSTRUC17ONS:See reverse side kw Ding arsuucfons. f
I.
NOTE 7blephme,Soda!Sea:4&Vert lens,state ideItfrlicaSan and federal identlicalion numbers ere orggtrralal under IC 6-% - 2- 1
CERTIFICATION STATEMENT - U
I(We) .i -A. ��w-.4,11 •lli_ a 4 4, • certify that I(we)occupied aspw7{r(Tp�v��f1 0 o
place of .. •- or am(am)buying the following desalted real..j•- under contract for which a Homestead Plupeli}Tdi
DedWion'.hereby datrned on the date this application is signed, (date of slgnahlm). I(We):
❑ Own ❑ Am(are)buying under recorded contract ,. , _e ' f
❑ Am (are)entitled to ocalpy as a tenant-stockholder of a cooperative housing corporation. !/���qqc�r�
❑ Have a beneficial interest in the trust or the right to oc ipy the property lmda the terms of a qualified9/rpear NsretWAY -I DITOR
❑ AUn(are)the shareholder, partner,or member of the entity that owns the property.
- .
Reoods%°Ste where tuned S recorded Rend renter Pape
. - PROPERTY DESCRIPTION - ' -. ° - _ ,
Canty Teems* Taxing Q9rt(ray,Sens taantp) •
Pam(rumor Legal desapdal I Is the rarely in questkrr
❑Real Prvmy ❑Annually massed noble b:as(IC 6-1.1-7)
If any portal at the asthma mumre ode lad net enssxeg one(1)am pal nvneciXtly sutards that sbuase is used to amen income,desate ere we at ration
of the property wiped to endues Insane.
. l l -30 — 4w - MD - I ql-C
:rCJfl- . `_r- .-.-- -.PROPERTY OWNED,ELSENHERE BY.CLAIMAIT .'IT 1r7`t °„•
sate,Carry.ad Township Is claimant vacating a nanestead?
❑ Yes ❑ No
• •.. -ordamart
I hereby untidy the above statements are true,correct and complete. .
....__ .. I-1rambamysDerA ea.axe.(ad ZIPm2) /mss 136•-
..._... v aSd . _!S.. aarr(an,tawaavac o :ra:e.ac ZQ'rab)
ASSESSOR USE ONLY _ .�[ . 'I ASSESSED VALUE HOMESTEAD VALUE .I - '(0,1-R SIIUENTIAL_
Land not aursadmmng residential improvements immediately (1) C ms' s ¢ -
Other land (2) ?r_.;"v iii— z-:_'_ x,-`.
Total land(line 1 plus fine a (3)
,v" S iA Residential improvements or Dwaine (4) r i.
F
ama asses mobReI f r K ii
manufactured home
Other improvement, (6) St: y.S:' rs
Total Improvements lute♦though line a) (7)
Toad value(line 3 phc line 7) (R)
I hereby certify the above is Sue.correct, °de or Assessor Data sued(n o my,yes)
and complete.
VtYYig aeon-Signature ctA:wbr Data signed(rasa di%Year)
.. ✓ ."- ,.:-'__STANDARD DEDUQTIOtd'ALLOIYANCE -- _ _ y,
20 pay 20 Lesser of 60%of the assessed vane of the homestead or$45,060.
Noturt lsiandJ g any otherptoNSbn,the sum of the deductions provided in IC 6-t 1-la to a mobile hone $
that is not assessed as feat property or to a manufactured home that is not assessed as teal property may
rotes of(f/2)of the assessed va of the mobile home or manufadhaed home.
°ale `T rr
0,STICBJ11aV:O1g113l-C arey nada fie-Ranged Copy-Tax:eyes
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