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CLAIM FOR HOMESTEAD PROPERTY TAX - - - YEAR
railE STANDARD/SUPPLEMENTAL DEDUCTION FORM -
1 � '' Seth Faro 5473(R17/1-16) 14C10
N yl Prescribed by the Department or Local Goverment Fisw
INSTRUCTIONS:See reverse side for Una ilsfixffms.
NOTE:Telephone,Sodal Seaeft(diver's fcense,sale Elenfacsdon and federalikararu rwmbes are conlderdil under IC 6-1.1-12-37.
CERTIFICATION STATEMENT � -
I(We) u IMAta L I <
. . rend`,that l(we)orsan i ( c te.:
place of residence or- (are)buying the( Wowing<.--. ..• ... • •perty under contract for which a • --�I P•e'; rt, —i
°� n is hereby claimed co the date this application is signed. (dale of Signature). 1(We):
�
Gem_ 0 n(are)buNng under recorded t_ JUL 0 9 2018
❑ Am (are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation.
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified persorW residence trust.
❑ Am(are)the shareholder, partner,or member of the entity that owns the property.
a.
Name a ntaame(bydntce) -
1 (V
_ SennC
CIE P-
_. _ .. r
Remmea once lent wtma is recorded Rid amber Page
' - PROPERTY-DESCRIPTION • - -, I.
Carey Toer Tang ddiid(ay,bon beret4)
Pace rata repel dnay<an `Is the propety it mpastiac
❑Red Prcpaty ❑Army assessed asobb tea(ICS1.1-7)
It er 1 part=gee reads is mums.ash land mI ameaap an(1)acre that i mmraateN swards that studs is used In mace icame,deaate be use and Paola
et em property filigree to modem inane.
% - 0L - 21 4A Go —000 . 63(4 -020
-..2--7,.-::f:,--- • _ _--PROPERTYOWNED ELSPHERE6Y,CLIf:iANTi- - ,_ -
Sala,Catty,ail Tosmhiy Is claimant vacating a homestead?
❑ Yes ❑ No
p dabnae n /A/'
. I hereby y the above statements are true,correct.and complete. Y , //�G"Iwo p -
xAddress d mad Manna/at meet,day,soda,and EProt) /�Acct//s el vacated`f hamsbd,deny iUdmtar and Gesf,dpi stale amdzlPmde)
(e39E. A Or- R3.sitka. 101/4-Ci(ooq
ASSESSOR jisE ONLY _ ASSESSED VALUE n- I :HOMESTEAD VALUE :_71 t O RESIDENTIAL- A
not y
Land t exceeding one(1)ecre lnunediate fir. t .f- '."�`
surrounding residential Improvements (1) `�-•m+*^ _?s'-'_-.... ..-it
�3
Other land (2) y_.:or_z:2T o:<rcx 't:
Total land(line 1 plus line 2) (3)
c-r.;
c,. -.s__ i.F_ _r.
Residential asesse mobile or Dwamr9 (4)
annually assessed mobile/
manufactured home Garage f
C 3e raj
Other Improvements (6) ;._.+: :y:T
Total improvements(fare 4 through lure 6) (7)
Total value (line 3 plus fuse 7) (a)
I hereby certify the above is hue,correct,
Sipatme of Moran Dux slang bra*day leer)
and complete.
VeiyIN action-SNnsafe of AwLmr Dam steed(=rah.my,Yeas)
• . - - = . - sr. `_%E-" STANDARD,DEDUCTION'ALLowArJCE.r '.. '20 pay 20 Lesser of 60%of the assessed value of the homestead or 505.000.
NoMfisancing any otefpreisim,the sum of the deductions provided In IC 6-1.1-12 to a motels home S
that Is not assessed as real popery es lo a manufactured hone that is not assessed as real properly may
not exceed one-hat(1R)dl the assessed value of the or nmendadbued home.
Drs timed(arra thy;Yea)
OIS0203U110N:Original-Carey Augrar.Fee-Stamped Copy-Taxpayer
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