Homestead_Hawes ,1St CLAIM FOR HOMESTEAD PROPERTY TAX FORM
r v;k STANDARD!SUPPLEMENTAL DEDUCTION
c . SON Se Form 5073lU7/1-16) HC10
�wr Premibed by air Department of trail Gaaee r*Faun
INSTRUCTIONS:See nee=side farfiang ingniC60123. D
NOTE Teleph one.Soda)Seada chimes Rome,slate,G3caSwt and reheat Ide. Gabon numbers am wMdentialtmdeer IC 6-1.1 7.
I(We) • certify that I(we)occupied as my(our)principal
place of residence a am(are)buying the following desalbed real property under contract for which a Homestead Property MIAMI i 018
Deduction is hereby darned on the date this application is signed, (date of signature). I(We):
❑ Own ❑ Am(are)buying under recorded contract - a
CI x
Am(are) entitled to oupy as a tenant-stockholder of a cooperative housing corporation. ,. • 41•1r);t
❑ Have a beneficial interest in the trust a the right to omtp)f the property under the terms a a qualified pre "t A 7: Y AUDITOR
❑ Am(are)the shareholder, partner,or member of the entity that owns the property.
- -
Casty Townskp Taxing dNii1(edyt town,toemta,)
Peal rester tege descriptor' Is ie property n quanta
❑Rad nail ❑Aravady assessed moNo tow(IC 61.1-7)
In any porton at the residema strv9ee or ma bW not exceeding one(1)awe that amadaaly surrounds that taumve is used to prolm booms.dasalbe tie use and Fallon
of tie progeny mixed to trollop icon.
• -i — 304 - - l c. •
iROPERTY,OWN ED ELSEVfHERE BBYCLAIh1ANT js- ;h,:; u _-,z;c- s-cri
State.Canty.and Township Is Claimant vacating a homestead?
❑ Yes ❑ No
Men at certify above statements are tole,correct,and complete. ��(a a)ei
Admix amRact(nmberand street city'.sees aid Mier) al vacated any and street,cry,sea. code)
5 Get:it S .
�' rASSE55OR USE ONLY ASSESSED VALUE HOt1ESTEAD VALUE - t Ot.RE510EI.TIAL'9£.,'
- 'I c.VALUE.
Land not exceeding one(1)acre Immediately
'
surrounding residential improvements (1)
Other and (2)
Total and(line 1 plus fine 2) (3)
Residential'improvements or
messed mobile Dwelling annually /
manufactured home Garage (5)
Other improvement) (6)
Total improvements(fine•through fine 6) (7)
Total value (line 3 pia line 7) (9)
I hereby certify the above is true,correct, S "tea Of R° Dar signed(=net�%
and complete.
Vadyhe anion-Sig afire of Andmr Oats signed(nmdlt day,sear)
£ - :-w �' ea. �1-STANDARD:DEDUCTION ALLOWANCE,-, s..° st $a„"- --
20 pay 20_ Lesser of 60%of the assessed value of the homestead or$65,000.
Nehea tendlng any atherprovision,the sum of the deductions provided in IC 6-1.1-12 to a mobile home S
that Is not assessed as real property ono a nvmdartred Mme that is not assessed as teal properymay
not exceed one-hal( tithe assessed wake of the or rr)anutacaa d home.
Spalve afudar Dar dented(mangy gaol
3 am l�
DISTRIBUTION:Orypd-Casty Auttori Re-Sapped Copy-Tye
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