HomeMy WebLinkAboutHomestead_Dunn fl.. CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
fA a ,1. STANDARD!SUPPLEMENTAL DEDUCTION FORM
State Pam 5473(R17/1-16) 14C1
Resumed by the Department of tour Goremoert Fiance
INSTRUCTIONS:See remise atde brgig nsbur3ons.
NOTE:Telephone,Social Sectsfra drivels lease,stab iciantranSOn and federal li*aaian numbers are carradeitaf under IC 6-1.1-12-37.
CERTIFICATION STATEMENT '
•
I(We) I ftma�.ti . •✓� certify that I(we)occupied as my(our)principal.
place of res or am(are)buying the following desaibed real property under contract for which a Homestead Property Tax Standard
Dad is hereby claimed on the date this application is signed. (date of signature). I(We):
Own. ❑ Am(are)buying under recorded contract.
Am(are) entitled to occupy as a tenant-stockholder of a cooperative housing corporation.
❑ Have a beneficial hda.at 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.
Names (•bgl _
.
TtJ
Name of daY ate sae(kta/name)
5one Security teller d dzaats spouse(last five algid I Ocher's ba®I Itivcsratbn I Oar number d dam=Yt spare(bat five dell) Issuing Sate
~cable oryaeppe:sal sparse doss not have a rood security number.) {$I
fix_ -w-R.-�,te, al-t-z L �.ri-..":.-:1-,_:CONTRACT RECORDED "-` - _':^l':p c _. �.�Flls :
If beep CO waac,Fee Sonde camera name JJii
Remwens Dike ware amwu rewind Real Mta JUL U 2018
cam Township Tifq •(cry,then,to r
(C/ VA v(l,!BSON COUNTY AUt?!TOR
Pall nsma legalu tame it Rie:tat y
Rtwarl ❑Merry messed metie rote(IC 6-1.1-7)
It any parxn d Ili reSOaGaI mumse ate lad not meetly ors ft)sae tam tmleday samadds pat at uavre is use.]to pns>a mom*anode the use end palm
of de pmaaly utbed b produce slam
26 - k — 1 6 -2,00-Moo. s3o- 024-
d-t - __-_, _a}.ems,_ 7PROP.ERTY OV/h EDELSEYfHEREBY.CI:AIh'ANT.., „-,n . _ ,.
// See,Canty,aid Tamgfip .
[/��V`y, Is uia)nhant vacating a homestead?
❑ Yes ❑ No
d
I hereby certify the above statements are one,coact and complete. 'II /s/,/ /\^
Address d contact(maned arc/seen,rue.state,and ZIP oak) e if
are .- aid-... ,state.mid Z�ada)
•,ASSESSOR USE ONLY -_ _ I -ASSESSED VALUE_,.r H• OMESTEAD VALUE 4...... -NON,RESIDENTIAL :'.'�+
Land not exceeding immediately ri-s7*S$S >"
_
surrounding reside/did bnprwemenb (1) .- - dpi 1K?? z -.�.=,
Other land (2) • #.11 _A
Total land(gnat plus line 2) (3)
Residential Improvements or Dwelling (4) vin$-` -7":44...•'l':.z°''.333,, :-
-d -. -.+� -k;r ..
annually assessed mobile/ _.:.�-Z_Y -c C; e s
manufactured nom. Garage (5) r„?2-v- .._-LL;s
Other improvements (6) .z. r'
Total improvements(line 4 through line 6) (7)
Total value (line 3 plus line 7) (e)
I hereby certify the above la true,correct,
Signature dAssessa Data dyed(Mon*my;peal
and complete.
Veiyng aam-Siau-wre of Aldan Data sidled Wade day wad
'r.2" '- • '- -.:STANDARDDEDUCTON ALLOWANCE-. .j -t '_uo _- _, -
20_pay 20 Lesser of 60%of the assessed vdue of the homestead or S45,000.
Nohathstandug any Other provision,the sum of the deductions provided in IC 6-1.1-12 b a motile home $
that is not assessed as seal property or to a manufactured home ma as real property may
not exceed one-hal(t/2)or the assessed vain or the mobile or .
SWareL Crofikw SIVtArlh Ca Oats stifled(ant;coy,
IASif✓lBI1T10N:Orman-Canty Andics,tae-sapped Cagy-Teye/er
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