HomeMy WebLinkAboutHomestead_Lundberg n r•.. CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
- - STANDARD 1 SUPPLEMENTAL DEDUCTION FORM
Sod Perm 5473(Rail-IS) HC10 2Q Ill
Presorted by the Demerara of Lard Government France
INSTRUCTIONS:See revere side for Ong 6nWCEons. ryvi 3 t i
NOTE Telephone,Soda/Sectailt driver's epense,state 6#rt5cayDn and decal Me2IDca&in numbers= ' under IC 6l.f�-73
r- CERTIFICATION STATEMENT -
• I(We) 1 1/1 W✓ \ ' ° certify that l(we)occupied as my(our)principal .
place of tesidenoe or am(are)buying the following described real-...- Ails contract for wham a Homestead Property Tax Standard
Deduction is hereby claimed m the date this application is signed. (date of signature). I(YNe):
X❑ Am
Own 0 Am(are)buying Lager recorded contract.
(are) entitled to occupy as a tenant-stockholder of a cooperative housing corporation.
❑ Have a beneficial interest in the trust or the right to occupy the property under the tens of a qualified personal residence trust
❑ Am(are)the shareholder, partner,or member of the entity that owns the property.
Name a�,ad rill) Tdeplx-n rveila a am:ve
c�.� �� 1 \ 12) 38l —00)2_ .
3mal
Y
Sated a
. . 'CONTRACT RECORDED - . _ -
e dryly a,contract Fee Sande carnets suns
Recorders office etwe organ is rewind Rowed tint Page
-• - - - _ - PROPERTY DESCRIPTION-• - _ ,_
�/�\{j yam) TavS Tarry dime(ay;tam blvrdap)
Peed � •
Lapel Aso a, b In wasters
`l Rel pppsny ❑Arvvney assessed noble lone(rC 6-1.1-7))
It any pat=a the rmpatd are a be land not eveedng me(I)ale eat Smeltery n, se b to5d to prints Yeah,desaee tie use end palm
Of the rmpaytared b pears imm
v PROPERTY OWNED-ELSEWHERE BY.CLAIMANT, - : ,
Sate,Crory.and Township Is claimant vacating a homestead?
❑ Yes ❑ No
I hereby eitdy the above statements are true,correct,and complete. X -_\ �1 ,-a _ —
Z3c7 (neater `sleet state.�'C Zif / \ arecaled hammed.Jetty enter eel>e�'4ay.stilt�and zpam)
1 f!V\ OJT d G
`ASSESSOR LSE ONLY __ I ASSESSED VALUE I -'HOMESTEAD VALUE ._.I f�LRVALIUENTIAL r..----=-12
Land not exceeding one ltl sue bnmealetety v-s §-)-
sutmundmp residential ooProvanenb (1) -+'% z a 3�.,t
Other land (2) r " -
Total land(line I plus fine 2) (3)
Residential ameNsa Dwellingp (<) �.t d ;:1—;S�?
annually assessedessed mobile I s y.. a A - -
1/4
manufactured home Garage (5) -,x -` _
DEC 13 20184iF(
Other improvement (6)
Total improvetnents pie 4 throogh line 6) (7) Q.____.--
Total rattle(line3 phis Erre7) (B) I ' •/moire
I hereby certify the above is we,correct, Sipelse Old GIBSO COU` I Y muUI)daNS'�ed(nnat4 rill:)can
and complete.
belying aMen-Semen of gutter Dal aiOled bank day,yea)
_. STANDARD DEDUCTION ALLOWANCE'_-20 pay 20 Lesser of 60%of the assessed vane of the homestead or$45,000. .
NotsehStanCarag any Other provision,the smn of the deductions provided in IC 6-1.1-12 to a mobile home $
that is not assessed es real properly or to a manufactured home that is not assessed as real property may
not exceed ore-hat(112)of the assessed vaeae of The motes home or home.
SOatre abudmr Date dared(rot't day,
�5�1ei S1k . c,23 l2- 17-\ •
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