Mobile Home_Collins of` '" CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
= STANDARD / SUPPLEMENTAL DEDUCTION HCRO
P.
State Form 5473(R13/12-09)
,� Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for filing instructions. �Th
.� } -- _ CERTIFICATION STATEMENT ' - �" "�` �� � "�.y, --`-c�-��T.
L.I,(lNe) f 1 4 i1�7Iflfl�i U L3 certify that I(we :-. ..d . fin I
place of residence or am(are)buying the followin• property for which a Homestead Property Tax Standard Deduction is her 2, ed
•
under contract on the date this application is filed, (date of filing). I(We): JAN 1 6 2014
-�L Own ❑ Am(are)buying under recorded contract
i LJAm (are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation -
El Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified perscaffig
❑ Am (are)the shareholder, partner or member of the entity that owns the property._•. —•_., ) a _ -3.°19NTYZpFrnirop•
``�' -*,e7-. " -� ",thtj '? CLAIMANT-51NFORMATIONca mss.'_„_ -=-_'i cL ..Ri.`-1i-,:3 L3-.`vpJ_ 4,
- r�s:2lfs�cc:=`
'Name of claimant(legal name)
- .M ls-- 1 CO 1 Iin-)s
.
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, Soda//l Security number of claimant's spouse(last five digits) Driver's license/Identification/Other number l Issuing State
.. -r:. : . CGNTRACT:RECORDED°,.: _. . : s_,r.. _ ,. -.:_li ✓ �t%t
If buying on contract,Fee Simple owner's name -
Recorder's office where contract is recorded I Record number Page
.i
. 1- +:°t -1. FROPERVADESCRIPTION.: .. . . k;- _.' _-
County Township GIBSON COUNTY ASSGSGRcity,town,township)
Parcel number Legal description Is the property in question:
do-44/r-0,,---0,90- d O /9 9/ ❑Real property Annually assessed mobile home(IC 6-1.1-7)
If any portion of the residential structure or the land not exceeding one(1)acre that immediately surrounds that structure is used pr uce income,describe the use and portion
of the property utilized to produce income.
PRORERT;Y,OWNED$V-CLiAIMANLIN OTHERCOUNTIES - it -- ._
County Township County 1 Township .,
I hereby certify the above statements are true,correct and complete.
Signature .claimant • `
(Address(number and street,city,state,and ZIP code)
• • ♦ , . m r. .4 4) 1 I g ci I- a.-1, -o j /A,/ _(/ -Co �0
V -r r,,t._.._' ' 'ASSESSED4VALUE HOMESTEAD ZNON•RESIDENTIA �f'
ASSESSOR USE ONLY -- _ TRUETAX.VALUE.
.” ._ ., --+_ ATa100%TOFaTT,VI4.c,.z�VALUE- _cl. 1VALUE:%
Land not exceeding 1(one)acre immediately
surrounding residential improvements. (1)
Other land (2)
Total land(line 1 plus line 2) (3)
Residential improvements or Annually Dwelling (4)
Assessed Mobile)Manufactured Home Garage (5)
Other improvements (6)
Total improvements(line 4 through line 6) I (7)
Total value (line 3 plus line 7) ��(8) \ 1 ,
hereby certify the above is true,correct, \ \ Signature of Assessor Date signed(month,day,year)
I and complete. -
Verifying action-Signature of Auditor Date signed(month,day,year)
tio .. :STANDARD'=DEDUCTIONALLOWANCE : r . _T, i
20 pay 20 Lesser of 60%of the assessed value of the homestead or$45,000
Notwithstanding any other pm vision,the sum of the deductions provided in 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 not exceed
one-half(12)of the assessed value of the mobile home or manufactured home.
Signature of Auditor Date signed(month,day,year)