Mobile Home_Martin (2) „,.."1- ,.. CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
4��y.,1; STANDARD!SUPPLEMENTAL DEDUCTION FORM
ifitirof S Form (R17/l-16) HOW
hce
Presorted by the Department at Leal Goverment Finance
INSIRUCTIONS:See:averse side foram bsbucsons N l II D
NOTE Telephone,Social Seurif%driver's tense,state idw&Sra5an and federalIderekaLol numbers we W ith!underIC 61.1-if''r-
I(We) a celtdy that l(we)occipied as mY olq)p141 )018
place of residence a*am(are)buying the following desalbed real property under mntrad for which a Homestead PropertyTax
�all�r�1
Deduction is hereby claimed on the date this application is signed, (date of signature). I(We):
❑ Own. A.Am(are)buying under recanted contract ).,I�-(I/y1q
❑ Am(are)entitled to oca.py as a tenant-stockholder of a cooperative housing corporation.
❑ Have a beneficial interest in the trust or the fight to occupy the property under the terms of a qualified perrsiiii§Wailirreacalre AUDITOR
❑ Am(are)the shareholder, partner,or member of the entity that owns the property.
- . CLAIMANT'S INFORMATION ' .. - -
name d Gtwd Vega/mine)
claimant's spouse(legal name) �. --1 \�V
3h aeX)n .(1\ascil so r, . .
”.t.&'>s _ r ->'..;ae1c. . ^w .em u-
a doing at=eam Fee Simple corers ants
RemaYa oboe eM2 axeashrecorded - - •
Reed rumba Pap
. - - PROPERTY DESCRIPTION - -
Casty Township Trig F('`1y, rr "
Pave ante legal daaaipcn Its the praety ii Pesaro
lCareal PacpatY ❑Annually assessed marts hone(IC 6-1.1-7) •
It wry portico d the residential struare or Me land no exceeding one(1)am the immecidely surrounds the mature is used a prom®income,desaee the roe and d attion
at the parry veined to produce Intone_
alto -u,- e- OD4 -Dec)
-,"` ` - -.¢ -.-J_ = -''PR•PERTY OWNED ELSENfH R BY '•IhiANT- . a . ._
She,Catty,at ieandry Is claimant vacating a homestead?
0 Yes Q)'lo
Squaw d daunt f� /-[
I hereby certify the above statements are true,correct,and complete. ( !l \^' ,\\`r�.�',p`+^
Address d contact(rxmbnraat seat city.were and EPooda) Attu vs hanesead y Y+m+eer
any and sheet,ay,abe,one ZIP coda)
o S St % .
LtASSESSED
T ASSESSOR USE ONLY a, 1. ASSESSED VALUE,,,;-i HOMESTEAD VA LUsEi +'- NON-VALUE ...,'';,
• Land not exceeding one(1)acre Immediately ;+`�- F-�
surrounding residential boprovemenb (1) w,g � -s.
Other land (2) Zvi C- _.,
Total land(line 1 plus Woe 2) (3) .
Residential Improvements or Dwelling (4) 1 alcreart:T:-' C.,._
annually assessed mobile/ _
manufactured hone Garage (5) f..F.'J 12245 * ::::'--5a_c`.
Other improvemenS a x- c"l
Total improvements(line 4 through line 6) (7)
Total value (line 3 pie line T) (B)
I hereby certify the above is true,correct, Signature of Assessor Date signed grew*deg legal
and complete.
Vaayi g amen-Sgau'ue ci Auditor Data signed(moah dall rear)
hi'g LOIVANCE._TC -- .- . tnsK7,...
20_pay 20 Lesser of all%of the assessed value of the homestead or 545,000.
Nohdhslanding say Other provision,the suns of the deductions pmsild in IC 5-1.1-12 to a mobile home S
Mans not assessed as realpmpey ores a maadamued home that is not assessed as teal popery nay
rot exceed one-ha(114 of the of the mobile home or manufactured hare.
•
Ylit\
DIsmoam0N:Original-CanyAuca r.FisSaanped Copy-Ta dare VV
Page 1 of2
� 1 MANUFACTURED (MOBILE) HOME PERMIT ,,
7 Stateah737a(R7/4 to) •
p®� py
\� Pr scnbed by the Departmento Local Government Finance 'k ,,'�
iyo o m 'ie hair pernii
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❑Section A For Moving - Section 8 Trans rung Title (NOTE Separate permits regmred if owner'In oils to both move and transfer title.)
_ INSTRUCTIONa '' '
I rr A ma 1'home majno(be moved from one location to another unf as th owner ob ams a permit to mo the mobile home from the county!insurer
IC 619c7-10 : 4
2„i„The Bureau Of,Mootor Vehicle may not transfer the t2e to a mobilehhome or cha e names in an manner on the titre'to a mobilehome unless theowner obtains a
` permr'to tlansler th rite mmth county!reasurer.(10 E117 f0) -r r ` t'rt' +! y �. .Y9.x v 3 a
3 cun&ytr asu�rers`all je p rmrtvhtch is requiredttoeither mo�ro or40nslerthePtleto a mobile home:if tile aressp ciallaassse menn• nts iot rest.penahe
• Jud, gam.ns_end musts! am�dueandpayableown rce'�r. -a.-z4 .?- vebe npaid�e pe�y:- -7sa sr ara t' /scra' )Th., ,as'u 4rmurst Issu 'the ,X"'
:peed not later than_h'(2)business days(excluding tteecends and holidays)a_eit date the treasurer_receives a c-p e:ed-n 3.apptcation (ICr-r,- 7,110)
• 4 A mobile home ownner :ho sells a mobdie_h�to another shall provide the purcha r with the.pemlri required be ore the sal rs consuu`mma ed This obtgabon'-''.'.
`` does not apply to a mobile home oPandfor sate aanaucbon under/C922i5orlc92217..(IC 61 J7704) Aperson who t7iscomms a Class C ,
nlril tgrix�'.IC 61 1 e7 74,xv r, i "D ae t s i r -- z e 'I �. s -Ft;.
5 tA,y mobile home owner must present a copy o tnrsperrnt to the Bureau off Motor Vehicles When apptymg for Mle tansfer, If the Mobile home is to b mord a
sepa permmrtmustereques'tedpnoitomovrng ' a ,+� r �s - -
6 A Form,f(Notice of Plapng pfMobile Home Upon Land or Lott)must befiled tah to assessor t rthm ten(10)days after the data ofp'a m4 n o themobile hone.'-
' ' (IC 61 17-3) b31 {'t-r e-r a t • 5 i /v
i;a ath.. .t ' :i , 'j•, x+,J ' r2, i1.-xi r 44_:., ,iG't' `r 4 -4'ec-.• .
7 7h requ,re n nt to obtan a perm t to move or trans rtrru to a mobi a home doe no a l to an abandoned mobs homesold a an auction and r/C 9-22 1 5 E :a'�`a. ,. I..c.,Lie ^`�+.1YV,:R \ ! iB a T. pprnr '1'ACt. f• :l i...dt C..�S ls.'_ -i< Y. Ti ' [ Ls' .:
NOTE ,-7Apermitto move or trans r title to a mobile home.expires nine} (90)days afe the dot the county treasurer Issued tt`4+fi ri Iheperm gv?
uphres+it becomesinvalid d me n t,must obtain a neirper mil' - • ;t-4w -'F t 4t. .. t
ATTENT104 sr 10VER�HAULER;OR TOWER - r t t 1 t° `3'''s'` t Ala # ▪ •e. l - t • fl• •
A pees who is Engaged to move as mobile hot me may not provid tha ssenn..e unless the o mer presents him wih apermit to mow the mobil home and r
theper-mt is dot d not more than nmety(90)days before the dateoof the proposed move-The mover shallfretain possession of the perms while the mobil
homes:inetranstt T e mover must return the:,petai to the:owneao tile'rnobg home wlien the move i ccomple d lie 6,1 1 7 11 ' i
i -� .y: o- t t . . .
- s x rr ; � a, ` 1s`.£�' `� ...7 c� 7':..s9�t� i � ;r`-ri lay.. x Y r
. e•�F ' t .., sac: `: '- SECTIONA:_h10:VING.PERtv1IT1 .'. ._+ .. ,t,,,.,i. +;ter-i.r fr.:; :'
" \1 -: 1}t 11 ..i t •• t• #;. I'Da z of ie sari a cf p mur(noa'h oil r .' ) _:
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AMi,e s(hpmbar and street:el:y/5E115A and ZIPCod ) .,rr.a Da pzmn esx pL (mote l(30jdays ate,ssdanc) a"3"i'711"y t R. .+sR.-. d ,r. ,
1. l ^I. >r t lam- t .:; h l
s
Pi grtnabi`c m ,
I V t)` Yin ' Drrfens cit • l hicle ident iz wn r tree -
P
4:4::::Lafrrr-cLrr-
Add so presz Ilc a on'(ndnW ands✓ _Co sta and Zlnc ^ I..oil i•y mapper / ) Affected parcel nurser
',.ddre s of ne ilaa,:91 ]u rbestreet.and city,sta and ZIP cod) " Cct_?L pion nurEgi
( F ) j .
' x t.. .SECTION B, TITLE TRANSFERCPERMIT { " -- r - a a
T of otr er'° '. t s :• - *
Address of owner(rim r and stree of stae and ZIP cod
din�, g(� 5 1 ) Dax of is uanc�cf ptzrtrrt(non,n day y art>
paS(J b t< a�(�`�r x al Oti o_, YiJ - l�'7(o t ;- , s/ D'▪ Ii1�21 A . -- a..a.. �W
Mire bf location mo t„ �(n rrbe aid street;aY ste and�LProd ) . x. Date lwmuternie (fin et-90)days a`-rd 'edissuance) s
X0(-b�iN1-MAI iJ. 5i7.i3L07i�t ` rttki:er 7s ) /! ''1G,6bt r i . lo`5`l e c,`t `, `a
P.If' o mobile hoome'fir _ , 'lr ?n year(( roxt J`t ' •Dimension 1 1 y"7' ^r v.7. v >;
� w
Nanie of put hale t N' x. � _ •
-. ���3.a, i � Fi^t�r� T 1, xlr.i r i'a _ t > n FXec dpru:lnuirbery PP '' .� o rig
> SVZ{, f'r^'',..F OIr~zi rt Cv: t} ,Svh Q�r\ MQG�r SO/l.rf ' i ..r: 3 i r�'j_Lt "a3 -' .�) Q r�
'Addryss of pur^naser(nurmb r enfd stye t.ar-.sae and ZIP rod) x.y ,X,t a -•^ < tf m _,t-s--lv��� my ,�ry.tr,y ?
A00 (JAiIQ>cr ZED7 j > P,-zOKA;: r' r�i'7 (o1 ' Jx4' . ...
is pu has r mo•ing this mobil-home? .� t i ).• - .
}�YeiS T' I•!D .y ' r - i •2, ^ v • i s '
-
i s'�' 11 .,..Y'tT 5 -
Y' ; Lr. •1 ... _.Le .o §t t;;-:.. tr a .vtl .7 Z 4t•- 1 � 1 -Z -_
.... r_ ° `r.:5: `' rt•,::i z a. z, :.`-c till ICATIONOFCOUNTYTREASURER ?'; :" "„ y2Z3 _ ?kR ar
.f•.acFR} `-a '1:Y. - ii> 1 'fl-n ge .. -Mt l Ti`iv.ri 'f5 Y A -5.. ],
_The,application tomove or transfer title(as indcated'above)'of above described mobile home has been revie red vnth the records In this office and-
I heroine-tiC;teal'!-all taxzsedue.on the mobile home have been paid ----;--,:-"Cr1 -i -"'r rBv •--": T c 1 --
SiTiOrgef Couil/Treavrer r� + t r - r t- .-:n w xu r
A n Ca nt7 t Da synod(twee ., ,y a
r - 'I7551 63/�. 4' , Imo, t +0 ,Y � (71 _ n ',
1t
DISTRIBUTION Ongmatt^Oviner of Mobile Home-Copy County Treasurer Copy County Assessor or Tovinship Assessor d•any -