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Homestead_Romain
1 CLAIM FOR HOMESTEAD PROPERTY TAX -- YEAR .. .,�' STANDARD/SUPPLEMENTAL DEDUCTION FORM Sara Faro 5173(R17/1-16) HOW Pres:obal Mite Depamrat at Lori Govavrert Fierce . -INSTRUCTIONS:See reverse side Punting iistuctons �^ NOTE:Telephone,Sala/Seaarry,drivers=sense,stale ideniticabon and federal lde a aton numbers are confidential under IC 61.1-12-37. �� CERTIFICATION STATEMENT - . • I(We) �L t 1 N4/:I_•1 r I_�.Sasans 1J certify that I(we);^•• p1 - my i��j l place of residence or am(are)buying the following desaibed real property under colrCa d for which a • _...,.•P •.- ' ,ix ' •and Si Deduction is hereby claimed on the date this application is signed, (date of signature). I(Wei: Can. 0 Am(are)buying under recorded contract DEC 3 2 18 ❑ Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation. ❑ Have a beneficial interest in the foist or the right to occupy the property under the terms of a quafrfied PP??�rbpppnnaf 1e51 n t� El Am(are)the shareholder, partner,or member of the entity that owns the property. 7JVt/A� ._iR Named datal( gat sore) Tm.waa ahi:art rPl�/.�/)2J4La Socd '.A ab,yiip m oatad,Fee Secede series name Raardsh office elree cortrad is recorded Reid number Page rPROPERTYDESCRIPTION ` County Tomettp Taxing dams(cat;tam be'nsNp) Pascal nrlber legal ancdpeon ise.4prcpat,in Peas CJJ,Real;anent 0 Arneay assessed cootie Mrs(IC 6-1,1-7) It any pa41t a me residential smears a me land in esae g one(1)acre that immed y=minds at structure is used b produce income,aeaalbe the use an portico al me prmmy Lazed to Pedro income aco -aa.-D 3 'o b© - Doa . '706 -0a4 . - . . PROPERTY OPINEDELSEIVHEREBYCLSIh1A Ni r._ ' _ _ Sam.Carty,an Township Is claimant vacating a homestead? qCm/ A ❑ Yes ❑ No I hereby certify the above statements are titre,correct and complete. if Nidess dared(number eel.meal,ca*re.and ZI -.. rimy Coombe-an #reer,by,sine,ern ZIP code) )O3 SK 4P l rimyct..Or�,4 • s ASSESSOR USE ONLY (ie ASSESS DVALUE __; HOAESTE DVALUe.,- -trOHRELIUEt.TIAL ,- Land not exceeding one(1)acre Immediately v 11.== surround7mg residential improvements (1) -x s*t ' Other land (2) Total land(line 1 plus fine 2) (3) Residentialimprovements improvements or Dweelng (4) i` - rs I - annual*assessed mobue l *.j Y manufactured home Garage (5) i_..,.4-2,.. _. -- . Other Improvements (6) __.. Total improvements(tine 4 through line 6) (7) Total value (tune 3 pits lux 7) (6) I hereby certify the above Ps true,correct, Sigr.e..ve of Assessor Da tuned Ora deg Year) and complete. Vail)tenter-Signature of&sits Om sigad(rr_+ah.dry,Yea) STANDARD DEDUCTION ALLOWANCE•. - _-.,, .. 20 pay 20 Lesser of 60%of the assessed ram of the homestead or$45,000. . NahM thstandrg any other provision,the sum of the deductions provided in IC 6-1.1-12 to a motile home $ - that is not assessed as real property or to a manufactured home that is not assessed as real proper may WI exceed as(t/q of the a ed value of the rmbee home or.manufactured name. RSTiOSUnON:Origiol-CartiAudN,F1>SSa ped CON'-Taxpayer Page 1 of 2 IN