Homestead_Ford $, CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
a.,,,....' STANDARD STANDARD!SUPPLEMENTAL DEDUCTION FORM
Stith Form 5473(R1711-15) HC10
Presented by the Department of taut Government Enema
INSTRUCTIONS:See reverse side twang instructions.
NOTE Telephone,Social Security.droves 6rense,able rdentrIcafon and federal iduC)bca5on numbers are cod - 37.
e 1 )Ls
I(Ale) Y _.Avaeloc aged as err(our)Principal
place of reside or (are)buying the following described real property under for which a Homestead Property Tax Standard
bed is hereby claimed on the date this application is signed, j f Y late o/� lure). I(We):
0 Am(are)buying under recorded contract
❑ Am(are) entitled to occupy as a tenant-stockholder of a coopeldtive housing corporation.
❑ Have a beneficial interest in the test or the right to ccapy the property under the terns a residence trust
❑ Am(are)the shareholder, partner,or member of the entity that owns the property. _ „ I tN7Y AUDITOR
CLAIi.1ANT's lriFORtdATIO1J _ _ -
Name tx tlaenet(legal name)
Soca Seardy minter at dements mouse(be The dy4) Dtn&s keno/l th ion n(Mer amber ddaman's spade(Iasi Me dens) lasting State
(AAp&.aMe cd1d buses spouse does not hae a saran seat*meter)
. - ,CONTRACT RECORDED. = i
0 buying of road.Fee Stab Caters an
Remtd°h office Were mated is recorded Read meta Page
., + ' - 'TPROPERTY DESCRIPTIOY - $ .? a . ::.ter' 4 `-_'z;t[-
w Casey Tashtp Tam;dead(rill:Caen twsmN
P)
4/1340n .
Pat Legs descreMon Is the nquestiac
Real prcpey ❑Annually assessed motae hate(IC 6-1.1-7)
If any paten of the residential mucose Cr ere lad not mewing one(I)acre oat inmedatey worts that etudi a is used to produce vmme,dmmle the toe and portal
of de popay tared be police irate.
Q1 - 1a - o1 - 2o2-0 00 . gt-to -ow
, . - -`PROPERTY OI'INEDELSEWHERE BYCLAIh 'Cr.-1ArI _ - :3: . .. r. :_si
6¢m,Carey..end Toens/10 Is claimant vacating a homestead?
0 Yes 0 No
I hereby certify the above statements are true,coned-and complete! - , OrAdAdd.d et carbsd rwme erad street et,ea*and ZEP=de) _� av �tl --_. Larr4 dN.stere.mEZIPcode)
i ASSESSOR USE ONLY S,. f i ASSESS O VALUE`-t'1 HOMESTEAD VALUE _ a+NOt1 R gL(UE TIAL..,- :
Land not exceeding one(1)acre Immediat&y - •• ./-
. �. ._. .-:is-
surroundmg residential improvements O1 - _ .... ^- %
Other land (2)
Toth land(line 1 plus line 2) (3)
Residential improvements or Dwelling (4) }
annua0y assessed mobile I
manufactured home Garage (5) v r.`
Other improvements (6) Lc- r -
Total improvements(line 4 through line 6) (7)
Total value(line 3 pits Ina 7) (8)
I hereby certify the above is true,correct, Sipsatae atMrws a Dab signor(ante day.yeas
and complete.
Vetyng amen-Signature of Anne Dab stewed(mottle day.Wag
.. - . a _ ,.> ... STANDARD DEDUCTION ALLOIYAI CE--a s..c ,, .. n v r ':.'a'
20 pay 20 Lesser of 60%of the assessed value of the homestead or 545.000.
Nofwi hstanotg any other provision,the sum of the deductions provided in IC 6-1.1-12 to a mobile home S
Mat is not assessed as real property wig a manufactured hone that is not assessed as real properly may
not exceed one-had(12)of the assessed value of the manriaclered borne.
Signalise c Dale speed(matt,day.
Sill q-7—C .
ERSTR1eUTION:Ongmei-Carey Auden,Ale-amped
Page I of2