HomeMy WebLinkAboutHomestead_Summers (5) PROPERTY vFJR E `P STANDARD SUPPLEMENTALDE UCT1 FORM
r►- ` SNP 5.n(R1T/1-5) HC10 a
Pwieea0 an Department of LOOS Government Rona MI
INSTRUCTIONS:See reverse side for tiling bcsbucb'ons
NOTE:Telephone Soda:Seam$x divers&cane state i lena:caron and federal i federal Identiacaffon numbers am confidential wxbrIC 64.1-12-37.
• i Mae) , Y that I(we)accipied as my(our) - Cel2p
place of residence n-am(are)buying the following deathbed real popery under contract for whkh a Homestead P.j�. Tax Standard 1)
Deduction is hereby calmed al the date this application is signed, (datcatag r r i A. -):
• are) entitled ro campy as❑a (are)bull1g a cooperative housing corporation. ON CO
Wit,A r/
•
❑ Have a beneficial interest in the trust ix the right to occupy the property under the terms of a qualified personal residence trust.Vh/Tr,
❑ Am (are)the shareholder, partner,or member of the entity that owns the property.
�
. N l
P��� , / Tom TmdiG •(rdY.Met lee?�Np) r �_ co
/70 luau need; easy wand= 1
Kneed property ❑Amvamay assessed moll fC 61.1-7)
It arty portion d the residential samara r the IoM not en:eati g one(I)ere that availably sure Out structure is used to poem income,dascnte the use and psalm
d the dropsy larded Io rd✓mexams.
aG - /0 -/i0,0/- O01-2/3 _ Oar j2
-rim k zti.csiPROPare,OWNED,EL5EwHERE BY„CI:AIm ANTS.t'mTs' ,Y.-:sivr -e.•7yrcgt.
Sta,Caret at Township
Is claimant vacating a homestead?
❑ Yes ❑ No
Square d defiant
I hereby certify the above statements am true,correct and complete. ��l1 ^�r1' ^^_^ ^l
Aden d mmd(ixetanl sheet city:sore.and ZIPcotr) cvawbdfv \. .. \`nl1 V-
.-wa0-...,sake- and Z�wb)
a f a. • a t 1.f 1■A1� eta " ilk%All■-_
ASSESSOR USE ONLY _ ,.l) ASSESSED VALUE,-' - HOMESTEAD VALUE FI NON-RESIDENTIAL
_ '" VALUE
smroundmug r�esideential improvements a��` (1) • - 3`Y' .:v.'
:L:•
Other land (2) 5 ,,�'`A.� -��:�(
Total land(line 1 plus line 2) (3) T 040. 6a. u/ £ � t ".... • -
I
Residential improvements or Dwelling (4) II" ( �?
annually assessed mobile l -4"'t - - r
y : .. � . :manufactured home Garage (5) -r• j4>», - - _ _ e
Other improvements (6) t_ 0-ir/ �'
Total Improvements(faze 4 through line b) (7)
Total value(line 3 pea Me 7) (8)
I hereby certify the above is true,correct, Signature dASSessr Date s (melt day,year
and complete.
Veilyuq edam-Signature of Autos Data sianed(math.My yeah
.-r w-e�-.r.v-.r ' -:.,STANDARD,DEDUCTIONALLOVANGE--;-t - -'
20 pay 20 Lesser of 80%of the assessed vane of the homestead or$15,000.
NoMiMStanang any otner provision,the sum of the deductions pmHded in IC 61.1-12 to a motile home $
that is not assessed as oral Levperty orb a manufactured home that is not assessed as mar property may
not exceed one-he!(f/2)of the assessed vain of the mobile home or nanue:lred home.
Gemara alAUdbr Dee sigma(rsmdh dsy.Yea)
DlSTR1aJROR:Drover-Cana:Cm Fiestermed Copy-TScaye
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