Homestead_Gruver - • • 7 "°a CLAIM FOR HOMESTEAD PROPERTY TAX FORMYEAR
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4•�;,;-:� STANDARD/SUPPLEMENTAL DEDUCTION
Smb Fenn 5413(R17/l-16) HC10
Prewmad by me Department or Load Government Finance
INSTRUCTIONS:Seeda'erse SecttideWrees cense, ors - -y
NOTE Telephone,Soda)SaaaaifX afriisYs bcense,state idrxt'Sraton and federal itivAYrX�h numbers are oombde+tral wader IC 61.f-
I(VLp) • certify that I(we)occupied as my(ow)principal
place of residence or am(are)buying the following desolbed real property under contract for which a Homestead Property
Deduction is hereby claimed a1 the date this application is signed, (date of signeh/re). I i 019
o Dom. 0 Am(are)buying under recorded contract
❑ Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation. per�t . s �❑ Have a beneficial interest In the trust or the right to occupy the property wider the terms of a qualified peas t res N COUNTY AUDITOR
❑ Am(are)the shareholder, partner,or member of the entity that oLvns the property. SOli�C
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- - ` - --, CONTRACTRECORDED I -II burg burg on catract Fee Simple oases It:.
Recorders oda Wve Detract is monied - Read oats Page
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PaadnataG�i' We deaapba t in o Property gs9iac,
�'Q2 p— CD•56/ op 0 Rea property /1,3v1y'Aiuumly assessed circle hump(IC 6-1.1-7)
t arty paean or she realists'amen a to lard not accedes one(I)eae that mmeciaRIy surrounds that Mare is used b matte income,donate pn use and portion
S to propaq,oz.ed b pmdm ism.
8 o—.Cb1 -nor
-- - - PROPERTYOWNEDELSBThERESYCLAINANT - ..
State,Candy,ad Toandhp Is aft vaa6nlg a la.•—sad?
0 Yes No
5maaae S claimant
I hereby certify the above statements are true,correct and complete.
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-ASSESSOR USE ONLY •__ .ASSESSED VALUE -�' HOHESTE D VALUEa_ NON-RESIDENTIAL..wv,.
Land not exceeding one(1)acre Immediately
surrounding residential Improvements (1)
Other land (2)
Total land(line I plus tine 2) (3)
Residential improvements or Dwelling (4)
annually assessed mobile I
manufactured home Garage (5)
Other improvements (6)
Total Improvements(line 4 through line 6) (7)
Total value (fine 3 pa fine 7) (9)
I hereby certify the above is true,coast, SignatureSAssesw Ora signed(malt day yaM
and complete.
verifying action-Sgnapae Seeder Des ern(morn day.Ws)
20 pay 20 Lesson of 60%of the assessed vane of the homestead or$45,000. •
NOMitsbntfing any oilier provision,the sum of the deductions provided in IC 61.1-12 to e mobile home $
that is not assessed as real property or boa manufactured home that is not assessed as real property may
not exceed o m haf(VW of the assessed value tithe noble home or mamdactured home.
Steam axe d Audxr Data aged(aMle der%sea)
OtSiRIB11TiON:Orfgial-DmxayAatlla,Fa.smw.d Copy-T
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