Homestead_Minnis (13) CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
Hs-
STANDARD HC10
;;; STANDARD/SUPPLEMENTAL DEDUCTION FORM
:; Sde Ron 5473(R17/1-16)
Presented by the Depvanna d Loral Government Finance f
INSTRUCTIONS:See teens d instructions.s.
f ;NO TE:Telephone,Soda!Sa mTy tees fcenae,state itlud7ca6or and federdl7der�n numbers am oon6deitialaderlC bf.f-f -
CERTIFICATION STATEMENT
I(We) /a / • _'J Vi certify that I(we)otnipceo as mY(oyf
place of residence or am(are)buying the fallowing desrnbed real property under contract for which a Homestead Property Tax vo'
Deduction is hereby claimed cn the date this appforation is signed, (date of Signature). 'e): t4
❑ Dun. ❑ Am(are)buying under recorded contract
❑ Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation. G/"SON Cr) 7 1Jlke
❑ Have a beneficial interest In the that a the right to occupy the property under the terms of a qualified persona/ es tlehot Ntb A
❑ Am(are)the shareholder, partner,or member of the entity that owns the property. on.
OR
. • . CLAIMANT'S INFORMATION - '. .-... ‘774-i..:.
Nacre at'tlg1 ' Vega/name)
aliment
✓.
If buying on comas Fee Shlele aweff nave
Remdels office where corned G recorded Revd smiler Rage
Township r Taxing (rpty,town,bwmldp)
Pat 02x., /2G,,C4,71 °
nm:ma legal dmvps Is therragaty n question yt Real prcpcty ❑Asraay assessed mote bane(IC 61.1-7)
amy ration of the read rPal sanmre sere land w emeedng ore(base that bvnedately su cen t that structure is used In padlre m o ne desate the use and potion
of ere property mitred m pretax*income.
103‘ i3-0207=o00.G99_ odd?
4 4' '=.v 'der. PROPERTYOWNED ELSEWHERE UY,CLAIhiAATt„r 7 P7..'.-,'C .. -".: z.
Std.Cary.and Township Is claimant vacating a homestead?
❑ Yes ❑ No
dated ff
I hereby certify the above statements are true,correct,and complete. K . 1 „ II,I/1 •
Addles d contact(muter wt ate ray.S and Z/Pcoee) Address a uhc s ({I veer ddstee4 city.rya.and zlpmea)t-n
-,. ,ASSESSOR USE ONLY _ (- -.ASSESSED VALUE_•.'y HOMESTEAD VALUE..[�� 10) R 4LUENTIALa;'iF
Lund not exceeding one(1)eae Immediately
surrourutmg residential Improvements ( ) - -.-- �.^• 'y-
Oder land R)
Total land(line 1 plus line 2) (3)
Residential improvements or I Dwelling (4) S s
annually assessed mobile I
I{ -_
manufactured home Garage (5) � -; r �- :-¢'
Other improvements (6) ,r _ 4 1"e
Total improvements(line 4 through line 6) (7)
Total value (fine 3 plus line T) (8)
I hereby certify the above is true,correct, SYtsasa dASressa Dab sign(nerelt dare tend
and complete.
Yard/so sedan-Slpnare of Aedrtm Ora signed(nmrlh,GOY.tea)
. •;.;. 'S�. te;LEI STANDARD DEDUCTION ALLOWANCE ' a ___,n ter. �� '•,J
20 pay 20 Lesser of 60%of the assessed value of the homestead or$45,000.
Notwithstanding any otherpmvism,Me sum of the deductions provided in IC 6-1.1-12 to a mobile home S
that is not assessed as real properly or to a mender:MIed home roans not assessed as anal pommy may
not exceed one-hal(1J of the assessed vats of the mobile home or manufactured home.
Square ofAUdtor Data deed(nsdc day,Yes
DISTRIBUTION:Oil -CoureyAss,,Ale-Sawed Copt.Tmgryer
Pagel oft