HomeMy WebLinkAboutHomestead_Rodgers CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
- STANDARD/SUPPLEMENTAL DEDUCTION FORM
Site Form 5473(R1711-1M HC10
Prescribed by the Deptenvt of tom Government Fiance
INSTRUCTIONS:See reverse side forhlmg 6ubucbont
NOTE Telephone,Social Seaafty.diets Arne,state loi.466.ciatsi and federal ides numbers are mp7den7al under IC 61.1-12-37.
• I(We)�( (14 °A & rS certify that l(we)occupied as my(our)principal
place of residence a am(are)buying Oowing described real property under contract for which a Homestead Property Tax Standard
Deduction is hereby claimed on the date this application is signed, (date of signature). I(We):
0 t7'urL 0 Am(are) hold rofunder recorded ra ive hod. ��
❑ Am(am)entitled to occupy as a tenahtstocMlolder of a cooperative housing corporation. 1pp�
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified personal er10�
0 Am(are)the shareholder, partner,or member of the entity that owns the property.
CLAIMANT'S INFORMATION - •
re - - • - •
Social
AUDITOR
Sold Secure/member or damaSs Wave(be 5w agar) Other's License I;detection I Other haled of dahnats a(Iasi eve ekes) Issued Slate
pipette:*aty ifappcersta spouse does cot lae a so der seaway nanberj
'_ CONTRACT RECORDED � - _
e hieing m=Cott.Fee Simple oases tame
Remde's odd Were=grad is recorded Record nmMs Page
- vPROPERTY OESCRIPT10N-- .. ..
Caret Toanslep
�‘bSOr� •IL.ba4. et_��
Ferro mars legs desalpecn Ie the ptopatyy Pastio.t
eta Ropey 0 A reey assessed amble tare(IC 61.1-7)
1 any port on d ere reddereael dudxe a the lad MI Catti ig ere(1)acre be imrodfly s nsd3 be endure is used to prosm'emma,describe to use sad paten
of tee properly used b produce in
al_-\g - 1 - Doti- 003 - Q1 - OS
- - PROPERTY OWNED ELSEWHEREBY.CLAIMANT-; t -_ . -'- '.
Sty.Casy,ad Towns* Is claimant vacating a homestead?
0 Yes 0 No
I hereby certify
the above statements are true,correct,and complete. pc.�_ "
.r
Address and(rrta[vat woof sib.and ZIP ) _Aar
....._at see .r�l:shb.and ZlPcvvp)
t A<Je- . , ..6s, �.
-.r ASSESSOR USE ONLY - si - ASSESSED VALUE__ ._.I HOMESTEAD VALUE _I NOU_RESIDENTIAL zyz:_
r.-VALUE
Lend not exceeding one(1)acre immediately surr (1) }tester `"-' `+S�''i _-.
ounding asentlid id bariovamenb -.
Omer land (2) Z..S 'c• 'tom ++
Eft
Total land(line I plus line 2) (3)
)i
nidental esileI ,_ -_r._ ��.. __,..-
Owererhg (4)
annually assessed mobile I - a
=radxhrred home —x Garage (5) ,rxy ff ..�
Other improvements (6) -. r _�„.;<4`e._- 3 C �(1
Total improvements(fare 4 through line 6) (7) G/B
Total valise V/ne3 pis line 7) (a) SON
Cn!A
eM cby certify
the above is true,correct, Sgrsae of Assessed' Dee silted(msa$Oct War !'/'yUDITQR
Vatyeg action.Signore ofArdbr Dery dCned(mat day.)ear)
_ _ STANDARD OEDUCTIOIJ ALLO1NAr CP. t"- - v � _ .
20 pay 20_ Lasser of 60%of the assessed vane of the homestead a$45,000. - .
Nohntstarldalg any otherpmvirion,the sum of the deductions provided In IC 61.1-72 to a mobile home § •
that is not assessed as real property or to a manufactured home that is not assessed as teal property may
not exceed aehal(VW of the assessed value tithe mobile home or manufactured home.
d Aufbr Oa'a steed Wroth.clay,
DISTRIBfON:Original-Carey Audaa.Face-Sapped Copy-Tmhpayer
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