HomeMy WebLinkAboutHomestead_Shhackelford CLAIM FOR HOMESTEAD TAX
PERTY
e. STANDARD/SUPPLEMENTALDDEDUCTION FORM
State Form 5473(R17/1-16) MCI
Presmbed by to Department al Loral formed Fin® - (Ql LQ
INSTRUCTIONS:See reverse sde fortbng iastrucbons.
NOTE:Telephone,Sadal Sea+rip;drirvers Icense,state ideiddcabon and federalidenttrafon numbers am congden6al under IC 6-1.1-12-37. WH
• • ��s CERTIFICATION STATEMENT �/
I(We) 0-0 Q,/1 • .- 9{ ra-0--'L� Cr- certify that I(we)occupied as my(cur)principal
place of residence or am(are)buying the following 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):
❑ Own. 0 Am(are)buying under recorded contract
❑ Am(are) entitled to occupy as a tenant-stockholder of a coopeiattk housing corporation.
❑ Have a beneficial interest in the trust a the right to occupy the property under the terms of a qualified personal residence trust
O Am(are)the shareholder, partner, or member of the entity that owns the property.
- CLAIMANT'S INFORMATION - -
Name d Witham(legal name)
Sods Seoeay anibr d damsel's sports(es the ) Diners brae l grm-52ion IOver number of de'vmmt's spouse gate.died Sat,
(A/plmde ooNi eplrcad'a spouse ales rid hare a acdwsevaynmm e-J �!
CONTRACT RECORDED,_: - ,•If toying mta1'rad,Fee Shape veers mine
CC 0.3
Reorders oboe where cameo is recorded Rand number Page - /. PJQ
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CIS
Canty - Taessh4 Tatting&Mot(oty,Nam;NeraNNA O' .
bL\DSC( e -Cf15\1. c
Pats matter lags dsaiPea+ h thtrY h ws>wn
LW-Real pwaiy ❑Area%assessed noble lane(IC 6-1.1-)
Ir arty paaon d awe resdrta!Oulu.or the lard rid Etg One(1)me that rnmedately samusls that sinus a used N pceo Ira denote the use and portion
d an moony Lazed to proems bone
- Y - ao — OoO . gn3 - (Da
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. . . .-'PROPERTY.OWNED ELSEWHERE BY.CLFINANT- -_: < ,_
Sae.Case.and Township Is claimant varafdng a homestead?
0 Yes 0 No
Sgulre d dairtmr nll Q.n Q-..
I hereby certify the above
sertrenis are tore,coned,and complete. �`��
(a Q• - -i 2SG(oh.O�.¢
Andress d=tan(number mished.dy,Sr.and ZIP cat) d mated Farmstead,dae(number dy,s3b,err/Womb)
Q. •
ASSESSOR USE ONLY '( ASSESSED VALUE ? ' HOMESTEAD VALUE :I t; VOI .V LIUENTIAL y."
Land not exceeding one(1)acre Immediately
surroundingImprovements residential Improvem (1)
Other land ? L c
(2) air_.ares.iVc-tr._ 7t37"1'S.
Total land(line 1 plus line 2) (3)
Rannually
esse mobileements I o;ve0bip (4)
manufacturedassessed
ased home I Garage (5)
Other improvements (6) 1 4 :
Total improvements(line 4 through line 6) (7)
Total value pre 3 plus One 7) (8)
1 hereby certify the above is true,correct. Sigaua dA«a..a Data Signed(mad.dux year)
and complete.
Verifying anon-Sigeedre dMxlbr Dale Signed(nnl.CLOY,/non
-:r STANDARD DEDUCTION ALLow 4cE _ - _20 pay 20 Lesser of 60%of the assessed value of the homestead or$45,000.
Notwithstandng any other provision,the sum of the deductions provided in IC 6-1.1-12 to a mobile home 6 that is not assessed es real property ore a manufactured home that is not assessed as seal property may
nal exceed one-hal(1/2)arlhe assessed vane of the mobile home ormamAacbued home.
Scruoseet Meet Onto'toed(myth.day,Aa) s
Dt61R1e1111ON_Ongral-Cooly Aud:a.Fae-Slanped Copy-Tayayr
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