HomeMy WebLinkAboutHomestead_Perkins (3) CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
STANDARD/SUPPLEMENTAL DEDUCTION FORM
/:.. See Form 5473(R17/1-16) HC10
Prescribed bide Department of tool Government Finance -- --
INSTRUCTIONS:See reverse side for firing 61suutons.
NOTE Telephone,Social Seaefry(divert license,slate idertfirtafron and federal kleabrcadon numbers are mnffttal wrier IC 6-1.1-1237.
CERTIFICATION STATEMENT
I(We) 1 / t /// !I/ �fi i._ 1_a . .fl '_ // . certify that I(we)oca. >• • - j.. j. ' •
pace of / .-a am(are)buying the roaming des abed real property under contract for which a Homestead P .... , -•• z' •-.I� .
ss • . is hereby claimed at the date this applcalon is signed, (date of- =.re) (
la Own. ❑ Am(are)buying under recorded contract
❑ Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation- APR 2 3 2 118
❑ Have a beneficial interest in the bust a the right to occupy the property under the terms of a qualified personal residence torsi
❑ Am(are)the shareholder, partner,or member of the entity that owns the property.
•
- • _
Patel number legal emot:on Is afa ladeerly In question
Real p'ccely ❑Mvaffyassessed mono honer(/C 6i.i-7)
If am palm d the respeal ante a the lard not exceeding ore(1)eva Sat inmeSaeb sarands the structure is used In aa4ce insane.daunt*Ole use and portion
ci the properly Milked to produce crane.
Z (o_ / 2 - o6 3o a Co JA / oz. g-
:.. r<-a rti u _` .iieirtOPERTYONINEDELSE:YHERE.6YCLAIMANT s- _
see.Casty,and Township Is claimant vacating a homestead)
❑ Yes ❑ No
I hereby certify the above stelarmsb are true,correct and complete a
Adaessd=tad(rve'6aardstreet r3y,affie,and➢Pak) r -..... .,.�.. . ... - . ..__ .. _-- n•-...
MI, A/. /I7 hl/C
,..ASSESSOR USE ONLY _ _ ASSESSED VALUE ` HOMESTEAD VALUE.'., .I -Noll-RESIDENTIAL
ssurourdmUalone(1)Sue 4rulsMlatey (1) - 'l'`P'L ix . .
Other land >.14 �1 ._
Total land(line I plus line 2) (3)
Rnuafly as eased mamea Dwelling (4) 1
mangy assessed mobile/ _ r.
manufactured home Gangs
Other Improvements (6) :et;c,a;4l.rr- -_ 'Tr;
Total Improvement.(hoer through line 6) (f)
Total value (line 3plrs line 7) @)
I hereby certify the above is tore,correct, Slps1°e of Assessor Data signed Mena dale year)
and complete.
verifying earn-Sgawre d Paden
?_ - -� •"'
-^--• .-= 7"..• STANDARD DEDUCTION ALLOWANCE', Ir.`
20 pay 20 Lesser of 6096 of the assessed vita of the homestead or$45,000. APR 2 3 2018
Notwithstanding any oterprovista;the sum of the deductions provided in IC 6-1.1-12 to a mobile home S
that Is not assessed as real properly or to a Manufactured home that is not assessed as real pmrefy may
not exceed one-hat(1/Q of the assessed vale of the mobile hams ornumfacW,ed hare. •
1—nu
$gWfedAloFb! ",
GIBSfa... C TY I ITOR
. _ifa. ii/ 1 . I.
DISTRIBUTION:ITION:Or4W al-Casey Aurlibar,FieScsn W d Copy-Timmer
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