HomeMy WebLinkAboutHomestead_Turner (8) H CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
art STANDARD/SUPPLEMENTAL DEDUCTION FORM
Sax Fara 5473(R17/l-16) HC10
Resa®ed by the Deportees or Lccal Government Puce
INSTRUCTIONS:See reverse side for tiling instru ions.
NOTE'Telephone,Social Seaaix dr4Ys it:ease,side ikon and federalidereifecffin numbers am co t5dentad fader IC 6-1.1-12-37.
CERTIFICATION STATEMENT '
I(We) r e er� L1r.� . Li r ne r certify that I(we)occupied as my(our)principal
place of residence or )btgog'the following described real property under contract for which a Homestead Property Tax Standard
Deduction is hereby claimed an the date this application is signed, (data of syrratum). I(We):
Q•43 . ❑ Am(are)buying under recorded nand.
❑ Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation.
❑ Have a beneficial interest In the trust a the right to occupy the property under the terms of a qualified personal residence test
❑ Arn(are)the shareholder,partner,or member of the entity that owns the property.
. CLAIMANT'S INFORMATION - , '
Na:n ddaxat(cgs/mums)
�(�. Na.��
Sorer Ssoei7 mntr at CSOats seams(Po Ne ids) Odrers 5aese I roOriYalia s I ants mart:tat dmlars Masse Oast T.?MI Isstrg Sae
(Agalmde Myaepprear!'sapays doss rind lase a saYzaearyameerJ
If arena on mmnest Fee Smut oars tame
Reorders rem where contract is heeded Rand runbr Pepe
Cart .• T -: Teens dstid(rah torn aananp)
1 bin. r cr1ceaczm.
Par r•rty Legal desoirlm Is in assert
ptpeny 0 Avasay assessed no none(/C 6/.1-7)
If ay paean doe raitaaial mums•a the Lind not a'ceei.g one(1)ace Oat immectely waits that structure is used to proh•'e income,denote the neat portion
ciao Pronely sebed I pram bon.
a -k a- eQD - 300 - 000 . -1 I Lk -rea3 .
- ' - - - PROPERTY OWNED.ELSEWHERE BY CLAIMANT •
Sate.Carty,at Township Is claimant vawtNsP homestead?
n❑ Yes o
I hereby certify the above statements are true,correct,and complete. r. \i ^ � X
Ammo of MOW(motor ms t.c2h sea l Meet and ZIP ACAdaesS ci f )a(av Wnberre thief,thy state,and 28rrm)
e2/014). 61r114.if St. W irc u 9 V D
. --ASSESSOR USE ONLY ) ASSESSED VALUE•T . rHOCESTEACI VANE. NOt RESIDEN \
2w`UE ,'�?
Landrwtes redingom(1)an ement, atey (1) - - l : rig, s
suaouuMmg rssidemdW vnprwemanb _
Other land (2) - V t
Total land(tine l gas lam 2) (3) Ac/R1 2 29.19
Residential Improvements or Dwelling (4)
annually assessed mobile/ e
d
manufactured home game (5) • s y
Other Improvements (6) .x F A '4,`.xt ON GOUH.TY 1,0°1TGR
Total Improvements(lam through
ugh e a) (7) GIBS
Taal value cram 3 pas linen (e)
I hereby certify the above is true,correct, Square dAssessor Dux deed(mar'.dux Tea)
and complete.
verifying mean-Squavm cAAimr Dee sss,and(r=01.dry:yea)
20_pay 20 Lesser of 6096 at the assessed value of the homestead or$45.000.
NohseJ7ffindrg any other provision,the sum of the deductions provided in IC 6-1.1-12 to a mobile borne $that is not assessed as mar properly orto a manufact ed bonne that is not rented as real popery may
not exceed one-hat(It?)of essed vale of the mob&home or manufadued home.
3.
Amda Data
MY,Men
Lk I lay v Q 1 •
06 �islmON:Oirigial-CareyAmt'r.Re-Stamped Copy-Tmrpsyer M
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