Homestead_Harvey (3) - 4 j STANDARD/SUPPLEMENTAL DEDUCTION EDUCTI N FOR YEAR
°+ ors Faro 5/73(R1711-16) HOW
Rasutbed by ee De{wuma et Lome Gwanoev France
., INSTRUCTIONS:See ewerse side for bring lush-actors.
NOTE Teleph one,Social Seaud%drMr's Manse,state idar55rafon and fatal lja6o.and!Saar ktenticabon numbers are confidential under IC 6-1.1-12-37.
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CERTIFICATION STATEMENT - j i'Cr-
l(Ale) I I•l I/ grai / �l _I —,'/.'_�...- L that l( _ i
place of residence aam(are) the t .y l
( )buying fad/owing desmbed real properly under ``. for which a Ho l - 'r» ••- tap
Deduction is hereby claimed on the date this application is signed, I (d of ;r. ):. .
❑ Own. ❑ Am(are)buying under recorded contract
❑ Am(are) entitled to occupy as a tenant-stockholder of a cooperative housing corporation. MAR 2 1 2018
❑ Have a beneficial interest in the test a 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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Sodtl -.-. nanbr. ,
- -
CONTRACTIRECOR'DED
11 buying On mtvad.Fee Seta 0Miers mune
Remdefs o6a where wmea is recoiled Reed natter Page
. - PROPERTY DESCRIPTION - -
- ')
Canty TonslP .. . ._. . ..
Parcel neater legal blur poverty' l•
❑Fled• I* if Amney massed nett lean(IC6-1.1-7)
/
it•. a ee residator CUCas a as land in accent);one(1)can t keedsely steoufds that severe is used a Roaos tae.desate es use aid portal
® a .�.._, : .m em z6,- /1- 3o - Z00 7a5.55c2- 02.1
z(o-//- 3o -a00 a° 3. 8'8 9 -o. /
rn.e�'..L .;=14!.A -i rPROPERTY.OWNEDELSE'NHE'RE6Y at.i.., r--4.-7,7c-car, . , atitc';...-
Dam Cam.and To."'a'e Is claimant vacating a homestead/
❑ Yes ■ No
I hereby certify the above statements are true,coned,and complete.
M6m amrvaa(=Sward wa0 ' .a> ... .
? 6 S
/J� 2
1 ASSESSOR USE ONLY ,t ) _ASSESSED VALUE., i HOMES 1 EnDyn LUE . NO'.-y SIIUENTIA,; if
Other land (2) i ?..- -
Total land(line 1 plus line 2) (3)
e a r Residential bepfdvernams or Dwelling (4) y ' d `�.
annually assessed mobile I
manufactured home age .s'"�-: -r
College
Otter Improvements (67 l:,.(s-
Total Improvements(line 4 through line 6) (7)
Total value (line 3 plus line 7) (S)
Signature aASUSSa
fo
I hereby certify the above is hue,correct, ''
and complete.
Ve iMlp action-Signature of Audbr a:..-;
ile Wiwi 111,
. . . .. °.- cam- :.STANDARD DEOUCTIO- (�2 A1LOVVANCE.7r,(Mire'. 'x ;c ,TR T ±:
® 20 pay 20 assessed d a
Lesser of 60%of Rae assed value (ha homestead MAR 21 2018
Nolnithstandl g any otherprovision,the sum Of the deduction provided 17 IC 6-1.1-12 to a mobile home $
that is not assessed as real property or to a manufactured home that is not assessed as real properly may ,
mat exceed oneh aa(t/ value ol the assessed value of the mottle hone or nerudachaed home. a,.ei
3!7:-•3471'.7.77
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DCTR@MaJ:Original-Carty Aura,Fie-Starreed Copy-Tmrpafa
Pape l o t 2