Homestead_Alexander (4) CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
STANDARD/SUPPLEMENTAL DEDUCTION FORM
Sate Ferns 5473OW /1-16) HC1O
esa P Led by me..I�..pt wTre-d Lead Government France
NOTE ebaphon See ialerse side for ar's oense,bom.
NOTE 7erep'ra+e,Social SeaaifX ether license,state ider165ca9Dn and/e4malltleraca(ion numbers we confidential under IC 67.1 �•-.
I
j� CERTIFICATION STATEMENT ' .(We) t4 ems_ a- Ilk . • 1ima certify I(we)occupied asmy(our)principal 'place of residence a am(are)buying the following described real property under contract fa which a Homestead Property ap
Deduction� is hereby claimed on the date this application is signed, (date of signahu mre). V /018
LL't7wn. ❑ Am(are)buying under recorded contract
❑ 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
COUNTY AUDIT l
❑ Am(are)the shareholder, partner,or member of the entity that owns the property. OR
- _
Recorder's oho:etas attract is remhd Record meter Page
•
Comb ` .. �r'�` iopv_hip
Q` Teem dstt loth:town,NwraAM)
( c,s( 1 r \ c\t-�LTV^n
Peal nx:ber tage WtrtVtm Is en property In gnmEcrt
0 Real g tety 0 Mandy assessed delete home(IC 61.1-)
If any port on of the residential cottons a the end not eaxetig one It)acre Mat innedas y coons ds ma swore is toed to produce scone desmtt the use and pearl
of en propety tCSted to crease bone.
.. s.- PROPERTY OWNED ELSEWHERE BY CLAIMANT `
ry.a rmdq . -
Sae.Cad To Is claimant va...Ac�tm...Ja/dng a homestead?
0 Yes IEl No
Sertmxe ofdaimat l
I hereby certify the above statements are true,correct and complete.
x IL b . u.Pti l 4
Address d aithd(mate-aid street**Mee and Z/Paoatr) Address d vaned hennaed,ay(number arc(greet city sib.end ZIP code)
+• 'c i)lt '5 }. rind na S
ASSESSOR USE ONLY _ I - ASSESSED VALUE -I HOME DSTEA VALUE :r �{hON-RESIOENTIAC t;'" r
...r
Land not exceeding one(I)acre lmoediately •--' 'er
-surrounding residential improvements (1)
Other toad (2)
Total land(line 1 plus line 2) (3)
Residential improvements or dwelling (4)
annually assessed mobile I
manufactured home Garage (5)
Other improvements (6)
Total Improvements(lane 4 through line 6) m
Total valtte (line dphs line 7) (8) _- - -
I hereby certify the above is true,correct, Squaae dAssassa Dios sign(rrmh,mX Yee/
and complete.
Vetting s]an-Sig ems oAmber Dab signed(nmtA day.Yee)
-- 'STANDARDDEoucuou ALLOWANCE - - . .+ ...
20_pay 20 Lesser d 60%of the assessed value of the homestead or$45,000.
Nohehstancit g any other provision,the son of the deductions provided in IC 61.1-12 to a mottle home $
that is not assessed as real property orb a manufactured home that is not assessed as real property may
not exceed one-hat(112)of the aloe of the mobile or mamdacbavd home.
ea nddor Date signed(morr%dry,Yee)
\Q -\2.
DISTRIBUTION:Odpid-Cory Audta.Re-Stamped Copy-Tamara
Page 1 of 2