Homestead_Smith (23) tits , CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
• .' STANDARD/SUPPLEMENTAL DEDUCTION FORM
` t,:ice Stab Form 5473(R17 l t-16) HOW
�f— ''] Prescribe]by to Department at Lund Gore tr ea Fin®
INSTRUCTIONS:See reverse side brill g instructions.
NOTE Telephone,Social Seaa tc driver's'cense,state ideethcalion and federal identicatron numbers ate co.tt£ral under IC 61.1-12-37.
I(We) t l•v' ) e certify that I(we)occupied as my(our)pnndpal
place of ' am(am)buying the tolloseng described real property under contract for which a Homestead Property Tax Standard
Del/uaon is hereby claimed on the date this application is signed, (data of signature). I(We):
Vim-' Own. 0 Am recorded(are)trying under recorded contract
❑ Am(are)entitled to occupy as a tenant-stoddwlder 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
❑ Am(are)the shareholder, partner,or member of the entity that owns the property.
- `eLPIrALNT'S INFORI.fAiIOU .. - - _.
t (legs m ramere)
ran.) F'I $J D
Sad Security amber of deign'spade(last Eve ace" Drives tame I Ideot inn l Other ream of date spouse(led rsa dg5s) Isom EYa
`ar�"e"" ape �I tapper(' "n2"' AUG 31 2018
- - CONTRACT RECORDED :: +
0brre g an contract Fee Setmle corers namelifiti i
{(r
. Remdes mica where connote maned Rmme$RbaON CO(" i? AULMTOR
Canty Township Taxing Rate(ate,town,ban ip)
Gcbuoo^ . 3` 51. .�`ys1`��^1�.`�•(
Pantl r.amr 'Legal J Is the popery In questors
❑had Paccar 0 A'wary assessed calla lea(IC 6-1.1-7)
It any paten d Ste residential Sautae a the ad net armor±a one(1)aae 11m immediately amends that aeons is used to aaxab tame,demote ee use aid porton
at to prrTety tared to produce inns
26 - 1-1 -04 -140o -col '3-la -021 .
. •'."--:. --PROPERTYOVINEDELSEYHERE BYCLAI61ANi . _ ..
Carty, :
Cat ,adTownsn Is claimant vacating a homestead?
tUn0 Yes 0 No -17
I hereby certify the above statements are true,coned,and complete. 'i ' _IAW-
col
l KTYa .rime era Z(Pwde
x 211 ( .117, ' 1 - a6c
ASSESSOR USE ONLY y . __l ASSESSED VALUE ,_I t HOt,1ESTEAD VALUE =I _ ^Ot'R SIIDENTIAL .•
Lend not exceeding one'( )acre Immediately ._.. E'.rt. 7 Z{
surrounding esidemulongsaenenb 1) F "5y .
Other land (2) 4.1 '.,:t-iFi2,i- +-
Total land(line 1 plus line 2) (3)
Residential improvemerds or Dwelling (4) 1 0 _1 . «' at-`+4-_ .-_
annually assessed mobile l A...-2,,,,,,,
ne
manua -..chired home Garage (3) ._<5 ..+-, .. . .-_.. 4,,,:
_-
Other improvements (6) 7.4.
.rt_.- �. .;:;?S --.
Total improvements(fate 4 through line 6) CO
Total value(line 3 pits line 7) 03)
I hereby certify the above is true,correct,
Square olAssesza ors aged(radix not Jell
and complete.
Vatryeg anon-SHnaae SAuda Data signed(morn.dad lea')
.-. - ,.s - ` ._
•
� .' ,_ ." •i` .r:' STANDARD O-EOUCTIOIJ ALLOLNAtJCE-,"_.,. , . ,e_�_ -o _:'•
20 pay 20 Lesser of 60%of the assessed ague of the homestead or 645,000.
Abhseasancf g anyone,pronsion,the sum col the deductions provided in IC 6-1.1-12 to a mobile home $
that is not assessed as real popery or to a manufactured home Thetis not assessed as real propedy may
not exceed ore-hal(IR)of the assessed vete of the mobile home or manufactured home.
azgned(tor*day wit)
Sheen; •- i tin . �2 31 ►$ .
06TRa mom:Original-Casty Ara.F6e51anped Ccc'y-Taspryc
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