HomeMy WebLinkAboutHomestead_Coomer (25) •-s...--...../.1 STA INDARD/SUPPLEMENTAL ODEDUCTION FORM IF I State Form 5473(R1711-16) HC10 RescribeC Mere Department or Loral Gaamma Anne
INSTRUCTIONS:See reverse side in,flung h,shvcflont JUL 1 2018
NOTE Telephone,Social Seaa4K driver's icense,state is on and federal idertracaron numbers are con5de Aar under IC S-1.1-12-37
I(we) l',1r1(Li S 4-0 P/ "- 4,Cite Cr.--. urero'Cy that I(we)occupied as my(g Pnnci
place of residence or am(am)buying the following described real property under contract for which a Homestead Prt9pelta
�Ded�uction is hereby calmed on the date this application is signed, (date ofsf tyla)U NT`(AUDITOR
LM'O*TL ❑ Am(are)buying under recorded contract
❑ 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 personal residence trust
❑ Am(are) the shareholder, partner,or member of the entity that owns the property.
afy,town nonslip)b I bSate
kl( Y\LC+Cr\
Pats eerie toga
I Is to ptpeWT quasi=
W-,'R eel ppprty ❑Ameaty assessed moan tame(/C 6-1.1-7)
If any parton at the Made/tit sincere or ale tale not easedsp ae(1)acre that nnte68Sly sinoint5 cat snare is used to produce umme dissents lie use and(ATOM
d to poppy usace to polo rummer.
Dom - 11-\a - 03 - coo dL-1\-la — OA .
trier .7:- y V. -.--.t PROPERTY-OWNED,ELSENHERE BYCI Ah1AN 7T yt :yE vf:CIS,
Sae.Carey,rd Tomssy
Is darlmli vacating a homestead?
❑ Yes ❑ No
Swam of datrtw4
I hereby oeufy the above statements are true,correct,and complete. t/ /Y O 6 „_ -
A to a mart(rat-ardsteet rib.ea end ZiPmdy n Address a veobd hoestst.amy'`(mmtlsrrJy-at mmeet,ay,sae,and ZPcods)
20 $ I1/, —re I1/41 r{, , RnQ _Atm .t _•
- ASSESSOR USE ONLY _ I 1ASSESSEDV LA UE'C' -HOMESTEAD VALUE t - j 't1.,..-- LIUEhTIAL :.`-
Land not exceeding one(1)acre Immediately h y a _
surrounding residential improvements (1) `* -zi., :V't 3
Other land (2) : &y. ?f
Total land Woof plus ane 2) (3)
Residential trprovements or Mean (4) 1 _' r c'S - -
tuft-
annually assessed mobile I
manufactured home Garage (5) -
Otherimprovements (6) '.c„fw a '��*:`.Y1
Total improvements(Pane 4 through fine 6) (7)
Total value (line 3 phs line 7) (8)
I hereby certify the above is true,correct °'tie 0/Assessor Date signed(nArdt dad 1eari
and complete.
verifying araial-Signore ofAudtr Date vgced Ora day,yea')
_�-
20_pay 20 Lesser of60%ofthe assessed value of the homestead or 545.000.
NoMfthstaadrg any omerprovision,the sum of the deductions provided in IC 5-1.1-12 to a mobile home S •
Nato not assessed es real property or to a manufadrnd home that is not assessed as meal popery may
not excee AsSiorha/(f?)of Nee value home or manufactured home.
d AUdar Date (ale�;)end
•
14C. —7 b signed -
DITIMB R1ON:Original-County Auditor,Fee-$arced Ccpy-Twister
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