HomeMy WebLinkAboutHomestead_Jefferies re CLAIM FOR HOMESTEAD PROPERTY TAX FORM
YEAR
��y, STANDARD/SUPPLEMENTAL DEDUCTION
`-`- -; Sta'awm5473(R17/I-19) 14C10
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Prescribed by me 0epartr.+6 of Leen Govenasc Pearce
WSTRUCTIONS:See reverse side for fns MMus:Cons
NOTE Telephone,Socal Segaif)t MYeh ciceroa state cFrd5ca5orh and/aderalidelffica6on numbers are mr6derftal under IC 6-1.11 2-37.
CERTIFICATION STATEMENT - - - ,,,,A,
I( ) a _ certify that I(w e)occupied as my(gtu'J�'._ii�t 112
pace of residence a am(am)buying the foliating desatbed real property under contract far whid)a Homestead Property ax Standard
Der hereby claimed al the date this application is signed, (date of signature). I(We):
•
❑ Am(are)buying under recorded contract. / •. a 'ii
❑ Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation. f��q�
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified prWrfa r derfa is V •UDITOR
❑ Am(are)the shareholder, partner,or member of the entity that owns the property.
• - • _ _ _ CLAll.14NT'S INFORMATION .. _ - .. --
tJaroS na t(legal mare)
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da • u `Tp c) bat1
,' > - - t1-.--=‘".
If buying an contract Fee Simple osener's name
Recorders office when corned is remand Rented ranter Pace
- •PROPERTY DESCRIPTION -
Casay Township Tieing Quaid(S'(bass fwsaNA) //���- D
�r• Ce�4 rl ._p>Leek\_1 . - c a\-5' C a -Vt ac)
Paced neuter lap/aesapEam t ea par pyr a question
VRea PaPay ❑Annalyassessed meek recce(IC 6-1.1 4) •
If any porno of tae residential minis or to bee nil aenaxe ore(1)acre eel immendely sinasds that=con is used b produce imm,&sane On use and paten
SS property?thud to orations nose.
Sap Cony,and Township Is claimant vacating a homestead?
❑ Yes ❑ No
I hereby certify the above statements are true,cored,and complete. - .
Address d mrest(omteeend semen city:state.and zwcobb) ii.iei . .•.... ` �
nos N• 3'rf/Sf P-ancrsacojN ,1 ( A •
1-.- ASSESSOR USE ONLY __ ,.I'. ASSESSED VALUE i HOf _E O VALUE-11I } } ?Ott R SIDEC TIAL .,,
Land not exceeding one(1)acre Immediately %i�'? :.r;
surrounding residential improvements ` �.xl'tE 4 :-..
Other land ® 1 20`�
Total land(line 1 plus line 2)
u 'Residential baprovements or cost
annually assessed mobile l
flit ^R ..
manufactured home Garage >j,tK tai-.z ,;--.9
Other improvemenb
Total improvements(line 4 through line 6) (7) .
Total value Vine 3 pits line 7) (8)
Sigmas.co:Assessor Dan signed(ran*dax egar)
I hereby certify the above is true,correct,
and complete.
nardyna win-Ognakee dhoti' Dan skirled(n1114 day,Yeas)
_ STANpARD DEQUCTON ALLOLNAIJCEaK, _
20 pay 20_ Lesser of 609e of the assessed vault of the homestead or$45.000.
Notw"Ctstai drug any otnerprovisims,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 manufactwed home that is not assessed as real property may
not emceed one-hat(1t4 of the assessed vane ofthe mobile hoe or rlumdactred home.
chafe oanypredlocr •—•i eta
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DISTRIermON:O. -CastyA'a OhnStemped Copy-Tw¢rer
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