Mobile Home_McClanahan .. CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
+_ _: STANDARD!SUPPLEMENTAL DEDUCTION -
xt State Fonn 5473(R15 1 5-14) HCI0
%� Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for filing instructions. I ! . .
NOTE:Telephone,Social-W- ,driver's license,state identification and federal identification numbers are confidential under IC:11. -12 i 7. 1 t i
. f, -`'• -���A, •. CERTIFICATION STATEMENT. •, -• ••- -":--' r ---r-=-r
®' I(We) �1 f AWl
certify that I(we)occupied as rpygyr)gi y 1
place of esidence or am(are/(flying the following described real property under contract for which a Homestead PropA lhx lidAU
Deduction is hereby claimed •n the date this application is signed, (date of signature). I(We):
❑ Own. ❑ Am(are)buying under recorded contract. I . �.
❑ Am (are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation. (,�pCC((l�A�II II�rr����uu
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualifiecgt75Dfid1ItrealeNrTr .A jJDITOR
❑ Am (are)the shareholder, partner, or member of the entity that owns the property.
-' r-+. S- 'CLAIMANT'S INFORMATION - - 2.-t a?n-.':c--_j
Na of claimant(l� _ _ ..:� f number of claimant
_I , // _ i 11� . . -a, /�. ,_ t-a/97
Social Seventy number of claimant e five dgis) Drivers license/ •en4.a5cn/• er nu pppher Issuin --
'i'/ of claimant(last live dgis1s— /� / / _
Name of damant's spouse(legal name) ►'/1 ( //,/`-�i
Social Security number of claimants spouse(last five digits) Drivers license I Idertitcahon I Other number Issuing State
of claimant's spouse(last five dg:ts)
_`t s7i17.' ^r- c:•CONTRACT.RECORDED.- = c - ec-z.i2 -�- Tom„ : n .-
If buying on contract,Fee Simple owner's name
Recorders office where contract is recorded Record number I Page
-r.',?- ��. _ _ 4�+=r._'>`PROPERTY DESCRIPTIONa-L-! s _._ . - f:, tv—C!bX_-= .
County Township Taxing district(rig town,township)
Parcel number Legal desaiption Is the property in question
❑Real property V Annually assessed mobile home(IC 6-1.1-7)
If any portion of the residential savcture or the land not exaedvg one(t)acre that immediately surrounds that structure is o produce income.desaibe the use and pot
® of the property WAS to produce income.
— '" 0 37—a0
Sae,county,and Township Is claimant vacating a homestead?
❑ Yes 0 No
Signal 1•clamant
I hereby certify the above statements are true,coned,and complete. , r 0-CLp
Address of contact(number and street.aty state,and ZIP code) •'I.ress of vacated ho stead,if any(number and street,city.Sate,and ZIP code)
7)( yr • -!" . )x.n _ -
ASSESSOR USE ONLY ASSESSED VALUE I HOMESTEAD VALUE I NON-RESIDENTIAL
VALUE
Land not exceeding one(1)acre immediately (1)
surrounding residential improvements •
Other land (2)
Total land(line I plus line 2) (3)
Residential improvements or Dwelling (4) I -
Annually Assessed Mobile I
Manufactured Home Garage (5) I
Other improvements (6) -•
Total improvements(line 4 through line 6) (7)
Total value (line 3 plus line 7) (8)
I hereby certify the above is true,correct, I Signature of Assessor Date signed(moth,day,year)
and complete. •
Verifying action-Signature of Melton A ( Date signed(month,day,year)
t' I
? i`'9 ',.. -is:^-�:_j STANDARDDEDUCTIONALLOWANCEr g-avaa'=v":= '. i"- --r
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 6-71-12 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(1i2)of the assessed value of the mobile home or manufactured home.
Signature of Auditor Date signed(moan,day,year)
•
DISTRIBUTION: Original-County Aadnor,HeSamped Copy-Taxpayer