Homestead_Schmitt (8) ,.-:a .,.• CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
4...;�,: STANDARD/SUPPLEMENTAL DEDUCTION
�,- '� Sts Form 5473(R17 r f-16) HC10
Rescued tore Department a Lead Gove(nm a Hose
INSTRUCTIONS:See eevmse ado forSLng instructions
NOTE:Telephone.Sodal Seadg(divert*cense stale iclenalcadon and federal Idea:Dragon numbers are CCnEderhal under IC 6-t 1-12-37-
I(We) /-olndQ/n e ` 2h/1) a Ce(Gy that I(we)ocoipied as mY(ma)pan
place of residence cc am(are)buying the following desolbed real property under contact for which a Homestead Property Tax A
Deduction is hereby claimed on the date this application is signed. (dale of signatna). I(W p �y A
Cif Own. ❑ Am(are)buying under recorded contract 'r 1Q�/.dB's
❑ Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation. C/e ' I �4')
❑
O
Have a benefidai interest in the trust or the right to occupy the property under the terms of a qualified persona/: -
- 'i T .. 8
❑ Am(are) the shareholdet partner,or member of the entity that owns the property. 0(1,S -
:.-
. ". -`
Tang told(r2):man tamer)
/11111-091)
Patti apse descripeon sc 'f ,/m Is to property ii aesfmcc
4/`?zs�/o , -y/.�T/ 4 R Real property ❑Aaaaly cussed mobil here(IC 6-1.1-7)
it am pass a to reddetfS attire a the land m raeeG' tag at(1)sae vetVlemedamN surascs that atomaei s need m peatca"vote.desmbe the use at police
et to properly Deiced to pradxa borne.
2e-, 5- z 5- yx a9Z. 065- ozS
r.:-, - "i.':• ....:PROPERTY„OWNED,ELsamERE::ETtcCAIh1ANT __ -'2; -, . '.. r;.2
sues.Cady,am Toenship Is claimant vacating a homestead?
❑ Yes ❑ No
swan a daifwa _ . a
I hereby certify the above statements are true,correct,and complete. , Lei A/ i .i:i. .
ArJdeva contact(weber eel abed.oats Cdr.and ALP-� ' Address a vacated lmaseatb wry(member em sheet ay:re.ald ZPSde)
11 Sr
r(— 9 4 .I D S J.f -4 / I' _i)I 7-
ASSESSOR USE ONLY - ASSESSED VALUE,' -,. ' HOMESTEAD VALUE 'I NON-REASIDENTIA C..
Land not exceeding one(1)acre Immediately c ' 1 $.- - yam'
:amending residential improvements ( ) -s K'2 -.- _
tza '.'tte -'7I-•s`
Other land (2) s-:: :T_'f,Y).-e;_utty'
Total land pine 1 plus line 2) (3)
Residtialbnprovbb m Detains (4)
assessed / _
x
_man (acbned home Garge (5) _,.�;4_: ^-7 _=z a_LLi_•
Other improvements (6) 'Gr.s...4.al.,�L ;y :a ;
Total Improvements(line 4 through line 6) (7)
Total value (line 3 plus fun 7) (a)
I hereby certify the above is true,correct,
Signature dAS5 ° pea Signed(rrmdt5 cox year)
and complete.
VadYag seen-SJQaare of lodax Dab synod(nrnra4 deg yea.)
-
x pay 20 )9 O— ” STANDARD-DEDUCUONALLO\VAr4CE.f ' - -
20 J h Lesser of 6046 of the assessed vaue of the homestead or$45.000. -. ..
NotwThstar7mg any other provision,the sun of the deductions povided in IC 6-1.1-12 to a mobile home $
that is not assessed as real properly or to a manufadw,d home that is not assessed as real properly may
not exceed one-half(1/2)of the assessed value of the=bile hue or manufactured horse.
Scrape dAadmr Dais signed(=fa day,leenl
tr/9-i8 r
asiRiminol:original-Carta Aut .Ra-9 iwad Copy-Tattler
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