Homestead_Jeffries CLAIM FOR HOMESTEAD PROPERTY TAX Faarvir
rt '�;:. STANDARD I SUPPLEMENTAL DEDUCTION
r\�'� ( Sena tam Serf(Rn/herb) HC1 1111 ' •Prescribed la the De{mEnanat Loral Government Finance •
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INSTRUCTIONS:See memo side for Ong instructions '�a3)T 2 2018 re.„
Telephone,Social Seaei%drives Ecerae.slate'd°red:ason and federal Ident cation numbers am cw6oY al under IC 6-1.1,
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CERTIFICATION STATEMEENT _
I(We) Cr -4- • a.l . 4 CLL�cc-c it t e)as that I(Wvpied as (dull place of am(are)buying the following descnbed real property under contract for which a Homestead P
DDeth9on is hereby claimed on the date this application is signed, (dale n7156t3-J m tTY Al.DITO R
[ Own. 0 Am(are)buying under recorded contract. Ci
❑ Am(are) entitled to occupy as a tenant-stockholder of a cooperative housing corporation.
❑ Have a beneficial interest in the bust a the right to occupy the property under the terms of a qualified persenal residence}nut
❑ Mn(are)the shareholder, partner,or member of the entity that owns the property.
- -
- • - .
Carey Township Teary drat(ai)c awn eerrap)
Pawl ember .._ legal aesraai is maston
eel flail 0 Annually assessed noble name(rC 6-1.1-1)
I1 any parten of the redden/MI sIudae or the lmq not exceeQmg one(1)acre that immetately Oneida that stoats•is red to proatre'vmane describe the use aid preen
of en popery milted b produce Income.
na av)-\3r \g -a oa - - aov - c Sara,Casty,and Township Is claimant vacating a homestead?
❑ Yell No
a cla
imant
I hereby certify the above statements we true,correct and mmplele. V
Address contact end
sheet.al.Cab-and ZIPcab) /L at a �
a m d-, m affisR rl):stab,end ZfPam)
t or,4- 3rd O• fan cis co,27/V.V%5 p
ASSESSOR USE ONLY i _ ASSESSED VALUE_x I HOMESTEAD VALUE,_si _ ?ION-REALUENTIAC
Land not exceeding one(1)ecre immediately ()) tgl si`, -
Surlounditlg residential improvement _ .>,. s�'t .l. :r. ..
Other land (2) •-rgrfNqi0g:Rgiri-i- 1-e-)ilE
._
Tod land(line I plus line 2) (3)
Residen iales improvements or Dwelling (4) ..ts-. 1-bc�- t_.r..:.
annually assessed mobile! -,
manufactured home Garage (6) _.-_4:...t_ _,� e,1 st- :�[,
Other improvements (6) '-T ln4 t f
Total improvements(line 4 through line 5) (7)
Total value (line 3 pie line 7) (8)
I hereby certify the above is true,correct Sigu-1se ofAssessa Oats signed(axon dal:rue)
and complete.
Verilyng action-Signatae of Auditor Dons signed Wadi day.)end
C4.-r C.. _`"y;,lap` a+45;t+-VyC ' . 7,;y STANDARD DEDUCTION ALLOWANCE-. " `y.;,ftyl -yes""'rgt
20 pay 20_ Lesser of 60%of the assessed villa of the homestead or S45,000.
NoMitlubnW g any other provision,the sum of the deductions provided In IC 6-1.1-12 to a mobile home $
that is not assessed as real property or to a manufactured home that is not assessed as mal property may
no teed one-ha,(Uq al thee value of the mobile home ornramdarbued home.
of Author Data signed(nark,dry.tee)
bi-k I it._0 tenst3L-
DISTRIBUTION:Odgired-OratyMdis.no- , M Copy-Tao?fer
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