Mobile Home_McGraw - CLAIM FOR HOMESTEAD PROPERTYTAX I YEAR
r �
�S..;;� STANDARD!SUPPLEMENTAL DEDUCTION
FORMTION
Sax Peon Sl73(HIT f 1-16) HC70
Presaitsd la the Desenme t cif Local Ooan ,t Finance
INSTRUCTIONS:See reverse side forting etsNx.Sans
• NOTE Tehyrae,Social Seaaifx&Vert kensestate idenfrScaron and federal idenfi&aSm numbers are con64:Cal under IC 6-1.1- -37. J
® I(WI) aW a certify that!(we)occupied as my howl;LYE '
place of residence a am(are)buying the following desclbed real property under contract for which a Homestead Property TA'- :•rdL O,8
�Deeduction is hereby claimed on the date this application is signed, (date of signature). I(We): C�
you, Own ❑ A1n(are)buying under recorded contract. �/(�,,, �1
-C Am(are) entitled to oaupy as a tenanare)b holder of a cooperative housing corporation. ((����pp��F�/rd l�rr� �{ �/
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a Qualified peTSM3Tf25ide1irY�{�LTY AUDITOR
❑ P.rn(are)the shareholder, partner, or member of the entity that owns the property.
.. . . _ -.._
Name of Goats page/name) -
•
Soda)Security minter of tlamea(bY eiv 6714 Drivers rmee I Idertiecaton/Oter norther ddsnanl(batthedggs) ISsgp Steer
(AppSmGb ody Scorecard does nal hawa aodalaepai nt y nweC) le
Name ofclaimant's spouse Vega/name) yl
Remdes oho°where meal is recorded Record meter Page
-
PROPERTY DESCRIPTION - - o
County Township Tamp*aria Ray,town,trsaMb)
Pate rumba Lege desaytaf 1 Is the property In yeslbc
0 Red property iic‘Arnmpy assessed moire nam(IC 6-1.I-O
aamm Ponca at the rside:mai sti se ct to land n exceeding ta eg e(1)ace t immediately wands that strum is used to produce em re describe the use an panto
• d to property mired to promise Insane.
26 — k28 -DOSD4- OO
--- r �_ minder--- 57max '- :,-- -Igi
- -- : -:_ � � �lP-a•ERTYOWNED ELSE:"MEREBY CCAIh'ANT -
Sxe Carty,and Toeshb Is claimant vacating a homestead?
/4 N Y ❑ No
I hereby certify the above statements are true,corned.and complete. N. .
do,
Adder d contact(menberand amt.db.stab,an ZIP ark) Aadmm of v-ir-•hcmeseal,a any .AT mtl&heat.oh:stab,and ZIP coda)
. a)3 s cr.sk%m.o. s+
,; • ASSESSOR USE ONLY - :_ • ASSESSED VALUE --frl H611ESTEAD VALUE :,1 rt;O'r-RESIDENTIAL
- ?",
Land not exceeding one(1)acre Immediately 3.,.-t< Z ."-'s
smnoondmg residential enpnaeo b (1) 'a k' 3"t -<
Other Land (2) ;r -L'r',he-K; 4�
Total land(line f plus fine 2) (3)
rillaIResidential nmrovemems or Oeegmg (4) _riNC-- Rs_,t .a;;. �t
annually assessed mobile/ e _L- -4
+ e
manufactured home Garage �'..'., �q-... '-su
s ..........................
Other Improvements CO _: E,.PS i':20,--,< s:�
vow improvements(lure 4 though line 6) (7)
Total value Vine 3 plus lie 7) (8)
I hereby certify the above is true,correct, Sig rose ciAssessor Date signed(rasa*dry,year)
and complete.
Vetyng exam-Si4naae dAudly Date signed(matt day,lea)
-
• 20_Pay 20 Lesser of 60%of the assessed v*se of the homestead or$45,000.
Nostfstandl g any other provision,the sae of the deductions provided in IC 6-1.1-12 to a noble home $
that is not assessed as real properly or to a manufactured home that is not ocean-ad as Mal property may -
rot exceed one-hat(1/2)the assessed value
value&thee mobile home ornaratectaed home.
d Sonar. Atcfmr 5he/WL Sly nj\ C 3
date C signedV 1 )
DISTRIBUTION:Original-CmmryAniom,ReStanped CCpj-Tayayer
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