Homestead_Dyer r CLAIM FOR HOMESTEAD PROPERTY TAX - - YEAR
^t STANDARD/SUPPLEMENTAL DEDUCTION FORM
.�' Stare Form 5473 pill 1l-16) HCIO
Pram-bed A we Depabnrt at Local Government Finn
INSTRUCTIONS:See reverse side tor Ping inch-scions.
NOTE Telephone,Social Secwtx divers Grease,slate idenfdca55on end federal Wer a numbers we confidential lacier IC 6-1.1-12-37.
I(We) _ v • • certify that I(vie)occupied as my(our)principal
place of residence or am(are)buying d real popery under contract for which a Homestead Property Tax Standard
is hereby claimed on the date is signed. (date of signahrre). I(We):
Owen 0 Am(are)buying under recorded contract.
(are)entitled to occupy as a tenant-stockholder of a cooperative housing corpcorporation.porati .
❑ Have a beneficial interest in the bust a the right to occupy the property under the terms of a qualified personal residence trust
❑ Am(are) the shareholder, partner, or member of the entity that owns the property.
Named drinrad( • •
G • J
Some
., - CONTRACT RECORDED - . _. -
abrary an contract.Fee Simple owners name
Ramrdefs 0e®where urged is roraded Rod nab, Pege
Y 9 • Towslvq Temp dwid(ay,tam,rUrraltlp)
ftrm aS'� Legal,I-.. Is se property in (
�r
El Real �. 1a
•�. � . - :.' Irzr(IC 61.1-1)
It any scan at the resldatalencase or as hind not emeedng one(1)acre ma inerradaely snare ma svuore is used to pcan ia>,ne describe the me are ponce
den ptperly taxed -
ol Me propoly tareetren produce incase. NOV 1. p.2018
aloe) 37 2_0 -SO tD -o . 1 . HCr —dOy
- - .. �PROPERTYONJNED ELSEWHEREBY.CLAIhtAFJT- .. ' .• -..-
saw.Caray,and Township GIBSON 10-1.,n ' Beam
Y El Yes '
I hereby certify the above statementsare tom,oared,and complete.X /ide® `
MN
es d m2 S 1, .a2.'n�md ZIP '� ' dam° ...a trammaa,alaae(ay ale.a,d ZlPaW>
E (A.�V 1v '
Oil RESIDENTIAL `
ASSESSOR USE ONLY = I ,ASSESSED,VALUE� :-I HOMESTEAD VALUE • -H - 'VALUE
Land not exceeding one(1)acre immedieteiy 43 p.C-e,I iifra-s i
ld surrounding resentiai improvements (1) `1y i>U .vt
Other land (2) + ..-
Total land(lie 1 plus fine 2) (3)
Residential bnprovements or Dwelling (4) 7 a..•r- _ ' '_? s;�'
annually assessed mobile I r. rt ,,.
manufactured home Garage (S) 4.,fre'0,' :_,,.4f.:..:...,.. ".
Other improvements (6) r„ -, ,- 4}.; .r
Total improvements(The 4 through line 6) (7)
Total value(line 3 pia line 7) (S)
I hereby certify the above is true.correct, Wean of Assessor Due egad(moreA dax Yee)
and complete.
Verifying rrMon-Sip+ceae alAu6sr Date steed(wroth day.we)
- _ � . STAWDARDDEDUCTIONALLOWANCE`. - -
20 pay 20 Lasser of 60%of the assessed value of the homestead or$45,000. .
NoMdhstandug any o he_rprovision,due sum of the deductions provided In 1C 6-1./-12 to a mobile home $ •
that is not assessed as real properly orto a manufactured home thefts not assessed as real property may
not exceed one-hat(I/2)of the assessed vale ofthe mobile home or man ( �a
% oaeor S\Ae SM1 C � ijTJ ' .
d$TW&InON:Orig'e d-CarntyAz tc,FileSlanped Copy-Ta:eyes 1`
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