Homestead_Kidd (5) -19. CLAIM FOR HOMESTEAD PROPERTY TAX Page! YEAR
e.
STANDARD/SUPPLEMENTAL DEDUCTION
11/4 Safe Form 5473(R17/1-16) HC10
Ptmmbed by the Department a lead Goverment Haas
INSTRUCTIONS:See reverse side fro Ling i,sbuctm
NOTE T Social SSCU44 drives icense,slate idsttrarcaSm and federal iderCficafr n numbers are ainedential under IC 61.1-12-37.
I(We) • certify that I(we)ocoi pied as my(our)principal
place of res or am(are)buying the following desalbed reef properly under contract for which a Homestead Property Tax Standard
Deduction' hereby claimed a)the date this application is signed, (date of signature). I(We):
❑ Own. 0 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 terns of a q alfied personal residence trust
❑ Am(are)the shareholder, partner,or member of the entity that owns the property.
abusy to contract Fee Semple men tare
OUNTY AUDITOR
C,tssON C
Recorder's office where contract is reread Rai ranter Pope
_ PROPERTY DESCRIPTION n. -
Canty Township Tamp debt(city.cam.ta*shi)
•Patel number Legal derott is to(=petty en giestiorc
❑Red(Nerty ❑A'avniy messed noble to (IC 61.14)
If ary ports a are redeertal strumre or me lad rot eutedng ere(1)acre that innerly snares that structure is used to produce hmms,desome Me use and paean
a the properly,ales to produce Yfmm
a% i a-o ti — lot- 001- ?ol oa.
_ -PROPERTYOVINEDELSE:YHEREBYCLAIh1ANi . _ . , _
Sme.Casty,rid Towaaiio Is claimant vacating a homestead?
0 Yes No
I hereby certify the above statements are true,correct and complete. -
Addess a coact(mrmberard street.city,date,and Z---.. ._.Nvameed i iseiad,awry(number and sleet.crux sate.end ZIc=Oe)
•
'ASSESSOR USE ONLY • y ASSESSED VALUE ' HOMESTEAD VALUE:- --NOrbRESIDENTIAL� ;y
Land not exceeding one(1)acre immediately .(1)
surrounding residential improvements
Other land (2) Fi '. .o._,_.....-
Total land(line 1 plus Une 2) (3)
.2r
Residential improvements or DweNrg (4) _-=
annually assessed mobile I
manufactured home Garage (5) �._. .x..: .. F.. .
a CI:g.
Other Improvements (6) _,.� ..�;` ,.__...-_. .-
Total Improvements(line 4 through line 6) (7)
Total value (line 3 pea line 7) (6)
I hereby certify the above is true,correct, Sigiaoae alAss•ssa Dos signed(mats�)sab
and complete.
Ve1yic actrtn-Signalise alk:ddr DEW dame(morn.dM.lea)
- - STANDARD DEDUCTION ALLOWANCE . : ..
20 pay 20 Lesser of 60%of the assessed vdue of the homestead or 545,000.
NoMydatard)ng any otherprowsnn,the sum of the deductions provided in IC 6-1.142 to a mobile home $that is not assessed as real properly or to a manufactured home that is not assessed as real property may
not exceed at(1/2)of the wake of the mob*home or manufactured home.
Signature of
PG) 761c7rjfilt
DtSiRIMMON:Oripeal-Dann Audta,Re-&anp•d Cagy-Taxpayer
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