Homestead_Sherman CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
y STANDARD/SUPPLEMENTAL DEDUCTION
Stab Form 5473(Rl7/1-16) HOW
Presabed by Na Dap:fluent of toga Government F1 a
INSTRUCTIONS:See reverse side tor!Rug insbuilions.
NOTE Telephone,Social Seaail%drivers license,state idertidadon and federal klenblicalion numbers are conlidential under IC 6-1.1-12-37.
CERTIFICATION STATEMENT
- I(We) At •ere u e a' - ��� . / / /l //i ../! certify that I(we)occupied - is--. (•i,).',
pace of residence or am(are)buying the fo0cwing•>•bed real properly under contract tar which a Homestead P • - 1'•. •. (,
Deduction is hereby claimed on the date this application is signed, (date of signature). I(We):
� 0 Am(are)buying under recorded contact. MAR 14 4018
lJ Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation.
❑ Have a beneficial interest in the trust or the light to occupy the property under the terms of a qualified personal residence Oust
❑ Am(are)the shareholder, partner, or member of the entity that owns the property. ei
I••. avJ?Iih
-'
- - - •Carey TonsNp Taaihp Janet(sly bon.bentao)
Paws amber Lags desap.on Is the Fepay F question
Res Pape ly ❑Akssnfy assessed noble f e(IC 6-1.1-7)
II any paeans Ne r de,taI saedlae or the laid not emx&mp me(1)acre Vet inrneasSnyy samait that amine is used b produce game decade 4e use end eon=
of the aopay tilted b produce Form
2 0 a -5S - oi7 000 790 0/ 8•
PROPERTY,OWNED ELSEWHERE VC R Th- =' - y;-.
State,Cary,aid Tomeip Is claimant vacating a homestead?
0 Yes (] No
I hereby certify the above statements are true,coned and complete.
Address at canted Muster ma ay,s3b- ziPOaf)
f "ASSESSOR USE ONLY, .-t cSESSED VALUE rgii HOMESTEAD VALUE.tx; •NON-RVALIUENTIAL';"Y`
- (1)
Other land (2)
Total land(line 1 plus line 2) (3)
Rasidenttai Improvements or Dwelling (4)
annually assessed mobile/
manufactured home Garage (5) .r•'s' f'
u } ti
Other improvements (6)
Total improvements(lute 4 through line 6) (7)
Total value (line 3 pus line 7) (E)
i hereby certify the above is true,correct,
Signature otpssassa Date rimed(morals MY.loan
and complete.
ve ytg an-signaave ot/tdbn Oats signed(nrva4 day:leas)
- "- SSTAtJDARDDEOUCTiOtd ALLOI•JaIJCE;t`;::- _2', 'r; ,-._"
20 pay 20 Lesser of 60%of the assessed vdue of the homestead or$45.000.
Noh+dhffir#wg any other provision,the son,of the deductions provided hi IC 6.1.1-12 to a mobile home f
that is not assessed as real property or to a mansdacturd home that is not assessed as real pmpeny may
not exceed one-hall(I/4 of the assessed yaks of the=bee home or nwztachnd home.
DISTRIBUTION:Orightd-Canny Akr®T•Fie-Sanpad Copy-Ta payer
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