Mobile Home_McNeeley J
CLAIM FOR HOMESTEAD PROPERTY TAX I YEAR .
At STANDARD I SUPPLEMENTAL DEDUCTION FORM
1 Stare Form S473('i2151 514) HCiD
'• e. Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for fling instructions. ( i
NOTE Telephone.Social Secunty,driver's license,state identification and federal identification numbers are confidential under/C 6-1.1-�'�. I l _ ��
( \ r I(we) ,AI/% (L:t/il"j.r certify that I(we)occupied as my(our)principal
place of residence or am(are)buying the folio . g describ'- eal property under contract for which a Homestead Property Tfi et{nrerdt 9015
Deduction is hereby claimed on the date this a •lication is .ened, (date of signature). I�fye): fI 1a L IJ
❑ Own. ❑ Am(are)buying under recorded contract. � "� �
❑ Am (are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation. C��(jy��
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified pels�a i y ve "AUDSTOR
❑ Am(are)the shareholder, partner, or member of the entity that owns the property.
_ :_CL4IMANPS INFORMATION - 1:� i
Nate
�//��
Social Seamy number of damara s spouse(last Are digts) Driver's tense/Identt action I Other number Iss vg Sate
of claimant's spouse(last ale dgts)
•
If buys g on canna.Fee Simple owner's name
Recorder's oftce where contract is recorded Record number Page
::_?.:.:-..-7÷7.-•:7' ::....r.-1-5‘ -4--J. PROPERTY DESCRIPTION`-_ -,. .y"'+la-yr;;,r..2 Y 4:1'<s•.
6o
Parma number Legal description/ 7 /� I Is the property in question:
• Q�,4 0 Real proper ualy aese-ssed rwbie home nc 6t.1-n
If any patron of the reside -I L^ATFe or the land not exceeding one(1)ace that YNMdsteh surrounds that S'!L'Cure S used produce income.nesmbe the use and pccsn
r of me property van-•t. ...., income_
(0 '_ —
-y - o ooy -oo •
Slate,County,and Township Is claimant vacating a homestead?
0 Yes ❑ No ` I'•
Si:rat or claimant — ^ /
I hereby certify the above statements are true,coned,and complete. ^ r y `c.„
(Address of coted(number and street My.state,and ZIP code) �r 4"a f vacated homestead,dl)any(number and my,state.and ZIP code)
ASSESSOR USE ONLY I ASSESSED VALUE I HOMESTEAD VALUE I NON-RESIDENTIAL
Land not exceeding one(1)acre immediately
surrounding residential improvements (1) I
Other land 1(2)
Total land(line I plus line 2) I(3)
Residential improvements or Dwelling I(4)
Annually Assessed Mobile/
Manufactured Home Garage (5)
Other improvements (6)
Total Improvements(line 4 through line 6) (7)
Total value (line Spits line 7) (6)
I hereby certify the above is true,correct. Signature of Assessor Date signed(month,deg year)
and complete. pt
signed Vadyig action-Signature of Motor �1 , 1 Dale d(month,day,year)
\ IV`
'32_.s_ . s. _1 -- -= il_STANDARODEDUCTIONALLOWANCE` s; > ,—ti-jam' ?. . T,
20 pay 20 Lesser of 60%of the assessed value of the homestead or$45,000
4/ Notwithstanding any other provision,the sum of the deductions provided in IC 6-1.1-12 toe mobile home $ ,
that is not assessed as real property or to a manufactured home that is not assessed as real property may
not exceed one-half(12)of the assessed value of the mobile home or manufactured hone
Sg:atne of Auddar Date signed(moth,day,year)
DISTRIBUTION: Original-County Aud:tor•File-Stamped Copy-Taxpayer