HomeMy WebLinkAboutHomestead_Gasca ,1$t. CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
E``\ STANDARD!SUPPLEMENTAL DEDUCTION FORM
r - Sn Faro s4ncRn11-16) HCIO
%4 aid Ptescbe0 try to Department of rod MOM-a Pearce
INSTRUCTIONS:See reverse side tor gang i sbuctont
NOTE'Telephone,Sodal Security,drier'license,state M &'S�n and federal I* cagon numbers are confided under IC 61.1-12-37.
I(Ale) VS C -- • y that I(we)occupied as my(ow)principal
place or am( )buying the following deathbed real property under contact for which a Homestead Property Tax Standard
��De,,//d is hereby claimed an the date this appfcation is signed, (dale of signature). I(We):
up Own. ❑ Am(are)buying under recorded contact.
Ti/ y Am(are) entitled to occupy as a tenant-stockholder of a cooperative housing corporation.
❑ Have a beneficial interest in the trust a the right to occupy the property under the terms of a qualified personal residence bust.
❑ Am(are)the shareholder, partner,or member of the entity that owns the property.
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_ CLAII.tANT'$INFORllATIOt! - -
Ngne.. .:_ •(toga! rm) -Tdeptne number of Claimed
save Sentry note or Vast fxhe'sliceue I bstfira n I Other nmberd drove(last the capes) 1ssmnpsa,
(Appeetb mtydagAsd not e...robed
�)�°r' I P 1 r
Namddarmsit'e spasa(a9drv+ne) Me'�.icoJ� "l`g`i t J ' -' qqy '1 )`I en •
So Se ref ncnhe d=ants souse(ON madam) Q**Cs Oceans I IdeKu'a onlater nmber of dbrnefl E)
Kuplaele adyeappearas space thee not have a exiel�aa�"yrrmmmxxeDeedkd ..}}p��
tE_ _rW 4 w *''Zfl.-: • TRACLRECORD • _+'
If timing a,mara,Fee Strode onsets name
2'2Dis
Readeh cam rase contract is recorded _ .
*1, ..-Tit .
GESSO y •r - "-
PROPERTY DESCRIPTION u
County 7 Tadao sac(of%many these*)
Padr•�'6e` lager CasertpropertypropertyIn g
m V� I Is Ms property V 0 Rea Pmpenr 0 Annually assessed mobia None(IC 6-1.1-7)
If any cabal of re nspe0al metre or tteland not esaedng me ill acre tetmmactisiely avrgeds not eaten is used to produce Income.desmte to use at ratan
d the property dazed to produce In
ab—lL- 01 - 4uj- ool ' g14o- - 01g '
.. - - • • - _
Stare,Casty,and Township Is claimant vacating a homestead?
0 Yee ❑ No
d
1 hereby certify the above statements are true,cared,and complete. /`�'�j a
Address
dmmd(rxrrtter ad sheet city,state,and ZIPnriy Addressof meted MSdeny r5straat dH.sr.and ZO'cade)
i 1C1 - 0\� g _
. .ASSESSOR USE ONLY , __..-I ASSESSED VALUE' q 1 .'HOMESTEAD VALUE.,1'' _Land not exceeding one(1)ecre ygLUEyTIAL,'","
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suaaunsmg residential Improvements tately (I) Ct,s -_saw Tt c'e S
Other land (2) ,_. ,` _4'9`eIc:r- '.-::
Total land(line 1 plus line 2) (3)
s
Residential Improvements rrt bile or Dtvdgmp (4) > -
annually assessed mobile I "
manufactured home Garage (5) e x•
Other improvements (S) :t r ...,,.
Total improvements(line 4 through line t) (7)
Total value (line 3 pre line 7) (a)
I hereby certify the above is true,correct, ire ofAc.r-er Dam signed(natty day,yew)
and complete.
w@Ih'ig action-Sb ne tire olAufmr Data signed(tnotall day,leer)
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20_pay 20 Lesser of BOX of the assessed vane of the homestead or$45,000.
Nolughstandi g any Ogler provision,the sum title deductions proided in IC 6-1.1-12 to a mbbae home $
that Ls notavvevned es Mal property or to a manufactured Acme Mans not assessed as real pro szcmay
not exceedCtaore-het f/t)�dtntlle assessed valve o7Na mobile home
'1o�mamdarbxed � -� '��
SpuaaedwEa ' \ I , \ ID �2,` r V '
CCS1( Cara signed larah,My,
DISTRIBUTION:Older-Casty Az a,F43anped Copy-Tamayer -
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