HomeMy WebLinkAboutHomestead_Barbour (2) CLAIM FOR HOMESTEAD PROPERTY TAX FORM
STANDARD!SUPPLEMENTAL DEDUCTION
Sire Fan 5673(217/1-15) HOW
fir Prescribed q'Na Oeya161att.r LOOS 6amrsmen Franco
INSTRUCTIONS:See reverse side for Ong auboctwe.
NOTE'Telephone,Social Seaway drivers license,state idenfrilcailon and federal IdeJ a6m numbs are c Mdential under IC 6-1.1-12-37.
_ CERTIFICATION STATEMENT •
two as �' A i f_ .L certify that I(we)occupied as my(our)principal,
place of residence or am(are buying the following described real property under contract foe which a Homestead Property Tax Standard
Dee is hereby claimed on the date this application is signed, (data of slgnaWre). I(We):
VG) Own ❑ Am(are)buying under recorded contract
❑ Am(are)entitled to occripy as a tenant-stotldfolder of a cooperative housing corporation.
❑ Have a beneficial hdaeet in the trust or the right to occupy the property under the terms of a qualified persona)residence trust
❑ Am(are)the shareholder; partner,or member of the entity that owns the property.
Naed derma(bgermeer v a
Social Security orator of dainerds spouse pan here dgas) Od.eta Irene./IdattirscaSco b Over nester of claimants spouse(last true dies) Issuing Sate
(App„'only if epp&a Ys spouse dues not law a serial seaeIy number.)
CONTRACT RECORDED= - V:0 ..;
F a e� _ - . a• .e s.
uMpirO m mmad.Fee Soda owner's name
Recorder's office where contact s reseed
...Nanlfr`w•I •1'
' -. .PROPERTY DESCRIPTION 1 :n -• _ e. rigs
Casey To.mhW Tamgdisaid( •lay Ate 6IYp) I. s- (/(1 `--1
Parcel amber IW-_l"_/_V`/V`•n l/
deaugrm Is the In
Real;mpg/BS /C 6-1.1-7)
If cry pomhn of the residential=care a the land not exaedmg are(1)sae that name telly sarastls that saumxe is used to pmdce income,desade
d ta-tSaandmtim
to property Witted to produce iron
26-1Lk- t$ - 303 -001 . 2g0 -007
Kra .�:.PROP,ERTY,OINNED ELSEWHERE BY.CLA MIA NTry „';
_ �C'=c"h-�LFt4. " -ate°:f':
Site,Carey.and Township Is claimant vacating a homestead?
x ❑ Yes ❑ No
I hereby Certify the above slad enlalt5 are true,cornea and complete. (`/�1'11p11f 1tlsomaa .
Address of contact(mmtrrtl the ray aS and Womb) lf{OAdteas S homestead cep Wederat street,cityl.aid ZfPads)
y i a
•
ASSESSOR USE ONLY I- 0" : ASSESSEDVALUE 4 HOMESTEAD VALUE'.,.� NO.1 EsiiUENTIALC:
Land not exceeding one(1)ave Immediately ="-
sonourdhlB residential improvements
Other land (2)
Total land(line 1 plus fine 2) (3)
Rasidendal Improvements or Dwelling (4) L s max. °s- .fix.:.
annually assessed mobile/
manufactured home Garage (5)
Other improvements (6)
Total impiu..,e.nts(fine 4 through line 6) (7)
Total value (line 3 phis this 7) (E)
I hereby certify the above is true,correct Slg w-tse o(Asaessm cab tiro(n.aeh dax year)
and complete.
VeraySig aeon-Siinre or/4,5Yr Dm signed Onrl4 day,)ear)
20 pay 20 Lesser of 60%of the assessed vie of the homestead or$45,000.
NohsiarsWrdl g any other provision,the sum of f e dada:tit s provided in IC 6-1.1-12 to a mobile home S
that is not assessed as seal properly or to a nraluadwed home that is not assessed as real pmpedy may
not exceed one-hal(ft dine assessed v m
ale Ube mobile home ornurrdadwed home.
Dgnatire&e, Dale signed(malt MX pro
DarRHUTi &ore-CareyAUL'a,Fm.sawel Copy- \`')
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