Mobile Home_Riley ,yam CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
-1.::-ac STANDARD/SUPPLEMENTAL DEDUCTION
FORM
_,State Fond 5473(R13I 12-0e) HC10
"--": Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for filing instructions.
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I(We) l it````----���� CI- � r I 9 p� kQ t2,t 1 certify that I(we)occupied as my(our)principal
olace of residence or a buying .
the of owing described real property for ich a Homestead Property Tax Standard Deduction is hereby claimed
40 Tamer contract on the d s application is filed, L(date of filing). 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
0 Am(are)the shareholder,partner or member of the entity that owns the property.
-TI4 Efs..At.4't r"+hz.`g.+.7tai/%i.i.:1k..!_-t"-' //,,, ..'i` :Y. CLAIMANT.S,INF.ORMATION.z.:-A:aSXL o artlti ra^+ �:v4'..r.Y. ];11W3WT:;;;-I.,a y c ar.
Name of claimant(legal name) 1 I
L. 13 a
t s itmr.4r j. 1/4.rZiWi L4.37.alt t`ct... _V.'CONTRAC1 RECORDEDi. +..3'.X,.N' r?r aR%'.e''«.r`_ti-:.'{rdi 4'Srait ,...r-.:; . i:3
If buying on contract,Fee Simple owners name
Recorders office where contract is recorded Record number Page
a%-.iatc`:=gRath, T--t-A.`%I.r:S Iafstkr.i _.igiff IG-r-- PROERT.Y;DESCFZIP.TION fel'C F ai: `V + 4 i.i"n •.t; '14':'"Se:t4
County Township Taring 7(city,town,township)
Parcel number Legal description Is the property in Question: r- -
❑Real property uatiy assessed mobile home(IC 6-1.1-7)
Iof any portion
proponof t the re identi sstr the land not exceeding one(1)acre that immediately surrounds that structure is used to producedescribe income, the use and portion
produce 0
Income.
_
96 9ZS - 0 aU — act
s 14' a t-v9ct`` „4 n:: k 'r'"r:�`'1riPROP,ERT;YiOWNEDBY.CLAIMANTi:IN OTHERiCOUNTIES;ai' '?a'tiyj w, : Y_ .445 ` �- rr�'-.'
.F -..l- AEI
County Township County Township
I hereby certify the above statements are true,correct and complete. Sign claimant ,\ , /)
Address(number and street,city,state,and ZIP axle) Il/Wjl�'//.� \
A 'P' 'eAESORUSEONY ^ :41,i TRUETAXVLE ASSESSEDVALUE,IC"HOMESTEADiz .{ NONrt RESIDENTIAL:4,1.z_+."
1.787 x.:!r2 ,-.7 .: :t..-o. F;4:a /rta4tf.,-c -s.._ , ..„ I.4AT•100%OFTTV li;4'4/AVALUE>.. tt F2;ix;Y7 i-VALUE. ii/Wi40 Lend not exceeding 1(one)acre Immediately w,Z sir tent -Per f,
surrounding residential Improvements. (1) 't;;-_:c �' � s"f',.+,'i '#'
S
Other land (2) -j y,_= i#-:I
Total land(line I plus line 2) (3)
,r
Residential Improvements or Annually Dwelling (4) „.;5. '2'dy' 4- ..-
Assessed Mobile I Manufactured Home Garage (5) = ,--. -s:K r� - t- `err✓ `Lir
ir,
Other Improvements (6) y'��.�._>t 3-
Total improvements(line 4 through line 6) (7)
Total value (line 3 plus line 7) (8)
I hereby certify the above Is true,correct, Signature of Assessor Date signed(month,daY.l�A
and complete. 1y�,� ' \\,, l
Venymg action Signature of Auditor rl •\, cw q\1\1r0 1 q Date signed(month day,year)
v'r 4i ox t -t yvk.>.W sd.STANDARL�.\3.D�\EDUCTION*-LOWANCE.s 4f7.:'>>w s. r i':Sa£'_..i4.g:e.+- w-..r.i ='E'<
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 that is $
not assessed es real property or to a manufactured home that is not assessed as real property may not exceed
one-half(1/2)of the aeve< ed value of the mobile home or manufactured home.
Signature of Auditor Date signed(month,day,year)