HomeMy WebLinkAboutHomestead_Bedaw Ar . CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
STANDARD/SUPPLEMENTAL DEDUCTION FORM
Scam Fora sa73(Rt7J 1-1e) HC10
Presorted by fib OCyaOVLL a Land Government Fiume
INSTRUCTIONS:See reverse side for rem loth-oceans
NOTE Telephone,Social Security tether's gcense,date Mentatetton and fetalldert>czeon numbers am confidential under IC 6-1.14247.
(date if 111419 J .
DAm(are)entitled to occupy as❑a tenant-stockholder lderedof a wooperraativee housing corporation. JUL 0 6 2018
❑ Have a beneficial interest In the trust 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 property.
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mcr rcy
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If tx*.g on eatact Fee Simple owns rare
Remma/s 06m wham axtruse recorded • RemOaatr Page
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Carer T eret T ' . (dry,ban baw
60 "rot)
Pared renter Lags descriptcn is the���Potent t ereseat
papery ❑mraaay messed motile lame VC 61.1-7)
If any paean of the residential s9>mre a the lad in Cveefap one(1)awe that inrtcdaelr arrant t that striatum Is mad in prods,boar,Oblate the use and ported
or to propaiy razed it pons,income.
a6- / — vim . 302 -co/ /5y 723
J.:.;'.. � :x2.rC.PROPERTy OVJNEOElSE:YHEREBY CLA�fnA.YT J•-;-C7277 •. .
aid State,Casey.a Tomato Is claimant vacating a homestead?
❑ Yes ❑ No
y clamant
1 hereby certify the above statements are true,correct,and complete. • ,/ I e • ..'.
Rams d camct Morn.etAen�meet cub sate,and zlPmdl) Address or.sated tmrw4aq t any(number end--- aatstate,edZIcode)
ASSESSOR USE ONLY } _ ,ASSESSED VALUE-*�dl .a HOMESTEAD VALUE j I N_0:1:1—/RESIDENTIAL 7 _'.
VALUE
Lend not exceeding one(1)acre Immediately
surrounding residential improvements (1)
Other land (2) ._1--: b;'.i- cx :S- t:
Total land(line f plus One 2) (3) •
Residential lb w Dwelling (4)
annually assessed mobile/
manufactured home
Garage (5)
Other Improvement, (6)
Total improvements(lire 4 through line 6) (7)
Total value (line 3 pits line 7) (B)
I hereby certify the above is toe,correct, Slpataa WASaaasa bat signed(nwc't clan yea)
and complete.
Vatting action $rat-$ reoA�ar _ Fitt
20 pay 20 Liner of 6096 of the assessed.due of the homestead or$45.000. JUL 06 2018
NalwLatancf g any other provision,the sum of the deductions provided in IC 6-1.1-12 to a rmbSe home $
that is not assessed as real property or to a manufactured red hcrne that is not assessed as real properly may
not exceed me-haf(1/2)of the assessed vale of the mobile home or mamdactraM home. k4rit-
5 � �� GIBE'ON COUNTY AUDITOR
D6IRIBUTION:Origins-CartyAa.FwSarped Copy-Tewaia
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