Mobile Home_Smith (2) I3 1
so CLAIM FOR HOMESTEAD PROPERTY TAX
. STANDARD/ SUPPLEMENTAL DEDUCTION a ;
ts
State Form 5473(R12/6-09)
Prescribed by the Department of Local Government Finance
DEC 0 9 2009
INSTRUCTIONS:See reverse side for filing instructions.
.r
- _ n CERTIFICATION STATEMENT - - • ' -
7[R
I(We) Qi eittu &- .1ceAift Viv6e tgita�I R -)principal
}, place of residence or am(are)buying the following described real property for which a Homestead Property Tax Standard Deduction is hereby claimed
/J under contract on the date this application is filed, (date of filing):
O 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
i.)) _ .CLAIMANT'S INFORMATION
Name of claimant(legal name 1�/�4 ,�//.---
to
Sodal Security ntxrcer of daunant(leaf five dgts) Driver's license/Identification/Other number Issuing Stater I
Sodal Security number of claimant's spouse(last five digits) Drivers license/Identification/Other number Issuing State
of claimant's spouse(last five digits)
- CONTRACT RECORDED .. - -
If buying on contrecl Fee Simple owners name
Recorders office where contract is recorded Record number Page
• _ PROPERTY DESCRIPTION - . . •
County Township Taring Ij ct(city,town(,township)
4/ Parcel number Legaall description Is the property in question:
/Y' to 0 03,r/ a n A9p s ❑Real property ]{s annually assessed mobile home(IC 6-1.1-7)
Gigany portion of the residential structure or the land not exceeding one(1)acre that immediately sun-ounds that structure is used produce income,describe the use and portion
of the property utilized to produce income.
dG .. 1dt-®.0a..2-6 0
_ - PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
,County Township County Township
nat of daimanlrr o
I hereby certify the above statements are true,correct and complete. ( g
Y .
Address(number- • f,city,state,and ZIP n,e) r
ASSESSOR USE ONLY _ I TRUE TAX VALUE I AAT ESSE OFALU I HOMESTEAD I NON-RESIDENTIAL
Land not exceeding 1 (one)acre immediately vre -� ire+>~b} -,rue. -:F3.gs
surrounding residential improvements. (1) vs'± -- `'� f ya.�+, r :
Other land (2) Li=F %rN f,'-,i.C•
Total land(line 1 plus line 2) (3)
Dwelling (4) a V,=� r F^ �-+f :
Residential improvements or Annually s 2..-a_ E-AAtb_g 's..ir a? cut
Assessed Mobile/Manufactured Home Garage (<< _ 't.+.,rz^ ,,,. v ; 'Cn
t
Other improvements (6) ,'£gip p;
Total improvements(line 4 through line 6) (7)
Total value (line 3 pits line 7) (5)
Signature of Assessor
I hereby certify the above is true,correct, \ g Date signed(month,day,year)
and complete. /� \r\I` I / (� r.
�;erifying action%\&nature of Auditor \'1 T \ \L `\, \I t\ i`t(u Date signed$C onm,day,year)
. _ . STANDARD DEDUCTION ALLOWANCE - .. . , , -
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 fo a 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)o/the assessed value of the bite home or manufactured home.
Signature- of Auditor n /�
�{✓, C/O Date signed(month,day,year)