Homestead_Schneider (3) _ CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
a STANDARD/SUPPLEMENTAL DEDUCTION FORM
cirfShod Form 5473(R17/I-16) HCIO
Presented by de Deft d Lcal Government FiMaa
INSTRUCTIONS:See reverse dde or tang nnrutn
NOTE Telephone,Sodal Seceaigt drivers&tense.state. and federal(4rn ru n nben are ca6dentialunder IC 6-1.1-12-37.
I(We
foOowing described real property under contract for which a Homestead Property Tax Standard
Deduction is hereby claimed ail the date this application is signed. (dale of signature). I(We):
Overt 0 Am(are)buying under recorded contract
0 (are)entitled to ocwpy as a tenant-stockholder of a cooperative housing corporation.
O Have a beneficial interest in the trust or the right to occupy the property under the terms of a qua00ed personal residence trust
❑ Am(are)the shareholder, partnec or member of the entity that owns the property.
If ants an anal-Fee Sipe comers rare
Readers otos wham contact S recorded Read runts Page
. - PROPERTY DESCRIPTION -z' _ ,. - - •"
Cony Taan�7hp/���� -/��N��+ Taxing*diet(thy,mart Asrrdnb)
Its the rin quest=
DCRed/moony 0 Annually assessed mobile home(IC 61.1-7)
It any pabn d to residents encase or to Ire nor eae g ae(I)axe That iirmacrairty snout tlst snare is used to pater ben,denbe Ire use and ration
d the prpxry tared b pv*aa idea
icW-fig -. - roo- tb- . 4a� _ Oa
-
- - _ ..
. - - PROPERTY OI'iNED ELSEWHERE BY CLAIMANT' -. r-. - - ,
Sum,Cam,,and Toenship Is claimant vacating a homestead?
0 Yes 0 No
Siwmrsa d claimant / .
I hereby certify the above staternalls are hue,correct,and complete. V r q
Address at anted(rontrand Meet city,sr.and 2IPmcb) Maya al vacated homestead,if am .••E,�-.},�.,aft Veto,and ziPam)
r3tt1 5. Ico i.—. f I- a,ct, ]„r 4x
ASSESSOR USE ONLY 1 - I ASSESSED,VALUE - 1 HOMESTEAD/ALOE '[.Otb ESIDENTIAL
land not exceeding one(I)acre Immediately t F-
surroundbgresldenttalimprovements (1) _���.r:2" ▪ 1, ..:y-
Other land (2) { �' % -`0�.
Total land(line 1 plus line 2) (3) \Q\
Residential improvements or I Dwelling (4) Y'▪ > ''-
annually assessed mobile! II- - ---- - -- - J? 'y LL_-<manutactered home Garage (5) �-
Other improvements le) :., z .P. r3..�1 aV
Total improvements glue 4 through line 8) (7) 6`aj5
Total value (lino 3 pita Una 7) (8)
I hereby certify the above is true,correct, SignaturedASanta Date s'�ed(nxvxq sax lay
and complete.
Wit action•Signature of Audis Date signed(mon*dirt seal
20 pay 20 Lesser of 60%of the assessed vdue of the homestead or$45,000.
Nohx"Jutancrg any ofner provision,the sum of Me deductions provided in IC 6-1.1-12 to a motele home $
that is not assessed as real properly or to/a�manufacsured hone that is rot assessed as real property may
not excee on d e-hal(1/2)of the assessedof the moat[home or Wane
titer corn(rroYll de tear)
�9ARti C . in. , t yv. .(O, I Date fa- -\ b
0.51WaURON:Origod-County/ballot FeeSairaed Copy-T ye
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