Mobile Home_Wilsonpar
n'" ; CLAIM FOR HOMESTEAD PROPERTY TAX FORM
YEAR
GREDIT/STANDARD DEDUCTION HC10
J State Form 5473(R6/4-03) +V y
Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for filing instructions.
Et 1" ".,,.ss n`.^ : •. ,r i ti}7 <_ �'F-v. �Fz.C... TIFI -POW STATEMENTM <n421 = V t W
I(We) certify that on the 1st day of March,20_
I(We)occupied as our rincipal place of residence the following described real property for which a Homestead Property Tax Credit is hereby claimed:
❑ I(We)owned Are buying under contract
(, Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is buying under a contract.
`c. % `�'x'eviz, i,covx:A- ge..a. s1T,' .:t;oNTRACTRECORDEDc'� t---zwch ``"'- -` ':se?i ':ssatir
If buying on contract,Fee Simple owner's name s,
Recorder's office where contract is recorded Record number Page
e,.t;=,i "' . -st au I _ 3v. 3"._ ,r _. _ _ . _ . e z - -f Si •1'a ;,.i h<r
�r-• �' t•: ._�..�. sxan^wa..��•..r�i-fs�%�m�4�i-r7";a'��-,-:PROPERTY DESCRIP.TION'�i•.
County Township Taring district(city re�wnsh
P r number F� I Legal description Is the property in question:
66 `I {p' ❑ Real property bile Homo(LC.6-1.1-7)
If any portion of the residential structure or the land not exceeding one(1)acre that immediately surrounds that structure is used to produ income,describe the use and portion
of the property utilized to produce income.
w'a'x>•. i„ t�c'7�:?pROPERTy OWNEDBYCLAIMANT:IN'7OTHEICCOUNTIES *Sri T Vim` I r
County Township County Township
I hereby certify the above statements are true,correct and complete. Signature of claimant
Address(number and street,city,state,ZIP code) •
t®
l,> � 'Ft yA ESSOR US ONON Y Yk tel .+ RUE'TAX � - ASSESSED VALUE NOMESTEAD NON;RESfDENTIAL ' 1S
a?.,: 4- a ayi.t. g f.>att,. ..?ti..,.�..��-�^„Vc st a tl- 'cVALUE z f.t .5;ftt:EIR%.9are72Y.6 i a4i VALUE #VALUE-t,�r:..'rs.%'
Land not exceeding 1 (one)acre immediately ,
ittTflt n ys.F,-kr1�mi,.gi.E1
surrounding residential improvements. (1) a. t -'
Other land "
(2)
Trial land(line I plus line 2) (3)
0, ' vF tl
Dwellin
Residential improvements or Annually g (4) t— xx' L' � sRL
Assessed Mobile/Manufactured Home Garage (5) art'•51As c1£k1`
WattOtitk-i
qo ._ r-.:
Other improvements (6) ',�s.,-',"y',x-1 �'`x-E
lin
Total improvements(line 4 through line 6) (7)
Tctal value (line 3 plus line 7) (8)
I hereby certify the above is true,correct,and Signature of Assessor Date signed
complete.
Verifying action-Signature of Auditor Date signed
lid< ': '£yA'-t=�l -itrifI aft 1 n3 `,t•.;fui_1!2:.,STANDARD;DEDUCTIONIACLOWANCE aV.„'9.,:s;;k Viz "' '' 3 ; iV
04. 20_Pay 20 R
Lesser of 1/2 Homestead R
vauauon or$35,000 \J 11
Signature of Auditor \\�1\\ Date signed
` APPLICATION FOR TAX DEDUCTION FOR DISABLED VETERANS, 43
WWI VETERANS AND SURVIVING SPOUSES OF CERTAIN VETERANS
Slate Fonn 12662(R9/5-06)
Prescribed by the Department of Local Government Finance
*RUCTIONS: Please check appropriate box(es)pertaining to tax deduction. (More than one box may be checked;however, a surviving
spouse who receives a deduction under Section IV may not receive a deduction under Section II.)
FILING DATES:
REAL PROPERTY: DURING THE 12 MONTHS BEFORE JUNE11 OF THE YEAR THE DEDUCTION IS TO APPLY.
MOBILE HOMES (6-1.1-7): DURING THE 12 MONTHS BEFORE MARCH 2 OF EACH YEAR FOR WHICH THE INDIVIDUAL WISHES TO
OBTAIN THE DEDUCTION.
❑ I Totally disabled veteran(or veteran at least age 62 with at least 10%disability)or surviving spouse-Not to exceed 812,480
Complete sections I,V and VI. (IC 6-1.1-12-14)
❑ II Partially service-connected disabled veteran OR surviving spouse-Not to exceed S24,960
Complete sections II,V and VI. (IC 6-1.1-12-13)
❑ III World War I Veteran-Not to exceed S18.720
Complete sections III,V and VI. (IC 6-1.1-12-17.4)
❑ IV Surviving spouse of World War I Veteran-Not to exceed S18,720 •
Complete sections IV,V,and VI. (IC 6-1.1-12-16)
N of applicant(first,midd e,last)
a mist-
Add (street and number,city,state,ZIP code) County .
Applicant ( does / does not ) own property with anotherindiviid1 V
ual(s)/beesides spouse and/or another veteran.
This application is made for the purpose of obtaining$s3ri 1 ", y deduction from the assessed valuation of the following described taxable
property for the year 20_
. Tawxip1J,Distri• (city,town township) Is the property in question: Parcel or Key r)tynberr -
Y . ' . P , a 0 Real Property ID Mobile Home(IC 6-1.1-7) ' f 7 d / ag if —�
r ` . SECTION I"- •Total Disability OR at least age 62 with at least 10%-disability . • _
A J Applicant was a member of the U.S.Armed Forces far at least 90 days(not necessarily during war one).
B. (8 Applicant was honorably discharged.
C. ❑ Applicant is: ❑ Totaly disabled;or .
IA At least age 62 with at least 10%disability
D. ❑ Applicant's disability is evidenced by liN Certificate of eligibility from the Indiana Departnent of Veterans Affairs;
❑ Pension certificate;
❑ Award of compensation from Veterans Administration or Department of Defense;or
O Veterans Administration Form 20-5455 Tax Abatement Certificate"
E. 0 The assessed valuation(at 100%)of the property for which the deduction is claimed(may not exceed$113,000) S
F. 0 Applicant is the surviving spouse of an individual who would have qualified for the deducton under this section when he or she was alive.
(Age of deceased veteran on date of death )
SECTION II Partial Disability . •
A. 0 Applicant was a member of the U.S.Armed Forces during any of its wars.
B. 0 Applicant was honorably discharged.
C. ❑ Applicant has a service-connected disability of at least 10%
D. 0 Applicant's disability is evidenced by. 0 Certificate of eligibility from the Indiana Department of Veterans Affairs;
❑ Pension certificate;
❑ Award of compensation from Veterans Administration or Department of Defense;or
❑ Veterans Administration Form 20-5455-Tax Abatement Certificate"
E. ❑ Applicant is the surviving spouse of an individual whn win iM have qualified for the deduction under this section when he or she was alive.
(Age of deceased veteran on date of death I
. SECTION III - World War I Veteran � . . - .
�'-1 Applicant is a veteran of World War I.
:Applicant's disabaity is evidenced by. ❑ Letter from Veterans Administration or Department of Defense;or
❑ Discharge documents '.
C. ❑ The assessed valuation(at 100%)of the property for which the deduction is claimed(may not exceed$163,000) S D. 0 The property is the applicant's principal residence.
E. ❑ The applicant arced the property(or was buying it eider contact)for at least one year before the date of this application.
- . SECTIONS IV, V, AND VI ARE ON REVERSE SIDE