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Mobile Home_Market CLAIM FOR HOMESTEAD PROPERTY TAX r YEAR -a STANDARD I SUPPLEMENTAL DEDUCTION FORM State Fpm 5473(R13/12-09) HC10 2011 HesmEed M me Department d Lola Government Fiance INSTRUCTIONS:See reverse side for filing instructions. / / ® I(We) SUE ANN BEASLE ) s certify that I(we pi s 1 ' n place of residence or am(are)buying Teal property for which a Homestead Property Tax Sandard Deduction is hereby Maimed under contract on the date this application is()ed, 02/22/2011 (date of fling). I(Wet. fl Own ❑ Am(are)buying under recorded contract FEB 2.4 2011 ❑Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation t� ❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified personal residenctC2. . ❑Am(are)the shareholder,partner or member of the entity that owns the property. v C Name of claimant(tegelname) TOR SUE ANN BEASLEY - CONTRACT RECORDED r". ' e.. a buying m mend.Fee Simple owners name `�` n Reorders office where contract is recorded I Record number IPage .•. ,.:PROPERTY DESCRIPTION. .- - y Carry Torn ship Tang disrid(m town.lonslQ) GIBSO �� PATOKA I y.26028 PRINCETON I�Parcel num•e `7 Legal desrrpice Is the pWerty it question: 26-428-05021_00- 1980 FAIRMONT MH ❑Red property 0 Annually assessed mobile home(IC 6+.1.7) ttmr/pobon o .resiencol structure or the land not exceeds g one(t)acre tat'Penedia:ely surrounds that soucvre is used to produce iron,describe the use and Purim at the property utbed to produce trtmne. °^'' "- PROPERTY OWN ED BY CLAIMANT IN OTHER COUNTIES _ • County township County Township GIBSON I PATOKA-PRINCETON GIBSON I PATOKA 1, I hereby certify Na above statements are true,cortpct and complete. Si' pw claimant /1 _ e 1 an& Address(number and street.icy state.end ZIPcodel �,�� V�tsi �,�Yl/y, LnVjl, ,, . 109 N 9TH ST,PRINCETON,IN 47670 ASSESSOR USE ONLY I TRUE TAX VALUE 'ASSESSED VALUE .HOMESTEAD'- NONRESIDENTIAL.` .'.- _ G 'AT100%OF ITV- .. VALUE,1 .. 'VALUE._ - ' Land not exceeding I(one)acre immediately (I)surrounding residential improvements. Other land (2) Total land(line I plus line 2) (3) Dwelling (4) Residential Improvements or Annually Assessed Mobile I Manufactured Home Garage ($) Other improvements (6) Total improvements(line 4 through line 6) (7) Total value (line 3 phis Tine 7) (8) I hereby certify the above is true,correct. {�f� Signature �o`fAs Sor `4(�' I1 Daz signed(moan,day,Tear) ® and complete. \� / \�\\� `\\� \� 3, VaYpg action-Sfgnatre d And in Oats signed(mmm,day.year) 20 pay 20 Lesser of 60%of the assessed vane of the homestead or$45.000 NoMChstardksg any Baer provision.the sum of the dedurins polled in IC 61.1-12 toe meals home that is 5 not assessed as gal property Of 10 a manufactured here that is not assessed as real property may not exceed one-half Nit)of the assessed rah+e dery motile lone or manufactured borne. Date:gned(month.dour./clad Somme of Pudtor . T. -rr -if" a Try