HomeMy WebLinkAboutHomestead_Hartley (8) ,.l ur CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
STANDARD/SUPPLEMENTAL DEDUCTION FORM
r t'y Slate Ram 5473(R17I 1-16) HC10
Prescribed A Pm Department at focal Gevema6 Frain
INSTRUCTIONS:See remise side for firing instructions.
NOTE Telephone.Social SeaagK diuera fcense,slate identrScaron and federal l n murders are mlfde:tar under IC 61.1-12-32
I(Y'la) certify that I(we)espied as my(our)pdndpal
place of residence or am(are) real property under contact far which a Homestead Property Tax Standard
Deduction is hereby claimed an the e this application net (date of signature). I(We):
❑ Own. ❑ Am(are)buying urger recorded contract_
❑ Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation.
❑ Have a beneficial interest in the bust or the right to occupy the property under the terms of a qualified personal residence trust
❑ Am(are)the shareholder, partner,or member of the entity that owns the properly.
Name al
)
Seel Stony niter of dz enfs spouse Matra caged Gaeta Ras.I WM6rdiinIOre nester of dermas space(last he Sods) IEm9`ate
(AryLaoe ayyteppe:arts space doss not have a nit)surly number.)
_
` .,goncaoct..,,e i . - iF:: `: 2� CONTRACT RECORDED ▪{''t y°-5`E t
tbtryvgsanaacl,Fee Svume amensnme
Reaedere o6ce slew seas is teepeae Red masher Page
. PROPERTY DESCRIPTION -
Canty Toeslap Tait/dimfa(al):is meralp)
Patsi cumber legd dsseee:on Is the property to gaeslbs
❑Reel ngcely ❑Atnapy assessed setae Mme(IC 64.1-7)
If any porban of the madar0S cntue or to aid not acs p.spe(1)one tel Tau, Sy mretra Oct Prestige is used to Pod re icon MEOOe cue use and nation
Ste Property Waned to pedlte beam N0 '
903 - ysa 39aa- 098
.'":PROPERTY.OVINEDELSE:VHERE6y,CIAIMAMT 7-; .- r. . --
6ate,Cony,and Township Is dabnad vacating a homestead?
❑ Yes ❑ No
d
I hereby certify the above statements am hue,correct and complete.
Aar of aeaa(nredsanl steel,tete stub,and ZIP coal Address a seated deny••. C MfrsA�-"tCJ 1��l asy(pE�3aeet air:sbee.and Zmsa)
_. I . 3 -_cue l • (a 1 V,
ASSESSOR USE ONLY ASSESSED VALUE: ,I HOMESTEAD VALUE':':� ( Irk 'RESIDEi1TIAL l
� {7 :VALUE. 1 h) �fI
Land not exceeding one(I)ecre immediately f' :gin r `.V
surrounding residential improvements (1) ! `°u- .-__..... .. .
Other land (2) " ▪v'a' n 3
Total land(line l pies line 2) (3) JUN 22 [018
Residential Improvements or Owenby (4)
annually assessed mobile I
mamrtxtured home Garage (5)
�':ky/
Other improvements (6) v >
--`�: =�3{RSOPJ COUM f`( AUDI OR
Total improvements(lint 4 through line 6) (7)
Total value (line 3 pits line 7) (8)
I hereby cattily the above is true,correct, `"4�ab-"e UASSessor 0a4 sib(mhorth,dux Yea)
and complete.
Vaayrg action-Squave daudter Dos steed(roil dsA gear)
;STANDA RD DEDUCTION_ALLOI'JANCE ;-20 pay 20 Lesser of 60%of the assessed rate of the homestead or 545.000.
Noteshstandl g any ommerpmvisba the sum of the deductions provided in IC 6-1.1-12 to a mobile home i
that is not assessed as real property or to a manuhWred home that is not assessed as real properly may
net exceedorre-l6/ti2mWassessed we of he mobile home mma,zhceaed home.
StyhadredAUdtor I Derr (nth,day.Yea?
A&, aa-J
a51R®IRION:Original-County AdCda,gee-Staheed Copy-Taxpayer
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