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Mobile Home_Marshall i �. CLAIM FOR HOMESTEAD PROPERTY TAX 9. ii! -? STANDARD 1 SUPPLEMENTAL DEDUCTION tTI \ ji,y.:. .- ` Stte Fonn 6-09 •s 1 Prescribed by the Department of Local Government Finance (-7 INSTRUCTIONS:See reverse side for filing instmotions. FEB 9 2010 _ -.: CERTIFICATION STATEMENT'. 1�1� I(We) /Mr 0"...t. / e / / certify that I(we).••+/: • atr)principal • place of residence or am(are)buying the flowing described real property for which a Homestead Property Tax 0144i�55 `tif'b claimed under contract on the date this application is filed, 4!NTY`A.0 �{ pp (date of filing): ♦1 INI�1 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 interest in the trust or the right to occupy the property under the terms of a qualified personal residence trust . • CLAIMANT'S INFORMATION. DESCRIPTION I - liaTownship Taxi_1:[=tact(city,town,townshi. 6 P,ar9I numbe Legal desaiption Is the property in ques'• r,q '= i % I I ❑Real property I Annually assessed mobile home(IC 6-1.1-7) _ I�f[�iita� If any portion of. e residential stnoNre or the land not exceeding one(1)acre that immediately surrounds that structure is u -•to• ••uce income,describe the use and portion of the property udf¢/ed to produce income. // 1 dl. - Ahla - o5V -00 , • - _ . PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES County Township County Township I hereby certify the above statements are true,correct and complete. - n of claimant J/`n, a I ••dre,ss(tut her and street,city tare,a • IP code) d •1 / E ' , f,, IP LLE JAI 17 . 5 ASSESSOR USE ONLY I,TRUE TAX VALUE,I ASSESSED OF TTV I HOMESTEAD I NON-RESIDE VALUENTIAL ' Land not exceeding 1(one)acre immediately - 3y vt 1 ” surrounding residential improvements. (1) Other land (2) :iMild "v Total land(line 1 plus line 2) (3) Y " Dwelling (4) 2.-E t F fr L- i zle .4 Residential Improvements or Annually ker Acsecced Mobile I Manufactured Home Garage (0) .C:1& ?w`ri s �: -6 Other improvements (6) :i'-,.-..t--r.,_„" Total Improvements(line 4 through line 6) (7) Total value (line 3 pits line 7) (6) I hereby certify the above is true,correct, Signature of Assessor Date signed(month,day,year) and complete. I Verifying action-Signature of Auditor \' \`J \15 \YS \\) Date signed(month,day,year) L D\\ _ STANDARD DEDUCTION ALLOWANCE _-• . 20 pay 20 Lesser of 60%of the assessed value of the homestead or$45,000 Notwithstanding any other provision,the sum of the deductions provided in IC 6-1.1-12 to a mobile home Nat is $ not assessed es reel property or to a manufactured home that is not assessed as real property may not exceed one-had(12)of the assessed value of the mobile home or manufactured home. Date signed(month,day,year) Signature of Auditor