Homestead_Galanos CLAIM FOR HOMESTEAD PROPERTY TAX FORS! /YEAR
ere
�J,e. STANDARD/SUPPLEMENTAL DEDUCTION ^ 1
Sea Fawn 54730317J I-16) HCIO 2019 .
Prescribed try the Department of In t Goverment Fiance
INSTRUCTIONS:See reverse side forming instructions.
NOTE Tel y±mre,Social Security,tidwrt fcense,state iden55caim and federal JOentolcafgn numbers are confidential under IC 6-1.1-12-37.
I ` en - CERTIFICATION STATEMENT - -. . . '
I Me)1 0`s 6 W certify that I(we)ocoupled as my(our)principal
place of residence or am(are)buying the following desahed real property under contract for which a Homestead Property Tax Standard
Deduction is hereby claimed an the date this application is signed, (date of sgnature). I(We):
,J1(Own. 0 Am(are)buying under recorded contract
Am(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 terms of a quaked personal residence trust
❑ Am(are)the shareholder,partner, or member of the entity that owns the property.
. . CLAIMANT'S INFORMATION - - - _
Name of cleans`e legalname) Techa
Seal Seafly amber or dwelt spans(ay,five bags) Drive's amnia I Ides 10mr rumba al ma's gaze gap 65a daft) hate Rae
(AayImte may aapprmrfl spare the Iat haw a scdy meaty mantel
_ is I I i fl—
•
CONTRACTRECORDED_ .- _ ..
If tufty on ora's1,Fee Shade mars name I I M.� �
oboe W • -I-
Rearfa oSan m e atarlem recorded ReadAlPRgr 1 1 1 1� 21. 4ae
. PROPERTY DESCRIPTION'-_ _ f-
Coate - Township? Twin,&Pict(cdy,town loniaNS) -
• TY AUDITOR
Peed Legal aucbaon h a
Rey PiVety 0 Aasatyassessed mobile hate(IC 5-1.1-h
It any parses Cl the resdeuay tinge a to let not q ore(I)an Sal itmataeb vs�ta =cas'e is used to Wave aroma aesalbe the use aid porno
d to pmpary mimed Oa crease inn
aG-1 a—,s - -LEDI - Qui - C 5g - oig .
- PROPERTY OWNED ELSENHERE BYCLAIMANT -
Sore,Cardy,and Township :Is claimant vacating a homestead?
❑ Yes ❑ No .
I hereby certify the above statements are true,correct,and complete. - / /a, / -
Addses*dcoat(mamherut street,city.the and ZIP case) Address al warded . --C. i (mamba st
reet,eat,city,sale.and ZIP cods)
•2-3 s ' i - lion—J,n— i1-6fiD L
ASSESSOR USE ONLY -j( :ASSESSED VALUE'-_, HOt1ESTEAD yALtE ;,..' NONRESIDENTIAL
surd unt edi�mro(t lacedl -mediaraN (t) —« '4-..y, . ✓ .r'-
Land notecedingon (l)ec . -ants . <
Y _..
Other land (2)
Total land(line 1 plus Line 2) (3)
s
Residential improvements or OWng (4) $` _
w
annually assessed mobile I
manufactured home Garage (5) S r.-2 ,` .
Other improvements (6) - - _
Total improverets(line 4 through line 6) (7)
Total value(line 3 phs line 7) (6)
I hereby certify the above is hue,correct, Sigaava of Assessor Dag a! ,ed tct.t my,.laM
and complete.
Vedy g atom-Swann oAudzr Dade»ged(month.day WWM
'�,r :L., 7 ±- _ . 1 , -STANDARD DEDUCTION ALLOWANCE ', - -r.- , -, -
20 pay 20 Lesser of 60%of the assessed vane of the homestead or 545,00D. .
AbteithstanGng any other provision,the sum of the deductions provided in IC 6-1.1-12 to a motile home $
that is not assessed as real property or to a manufactured home that is not assessed as real property may
not exceed ore-hal(1/2)of the assessed wake of the mobile home or manufactured home.
Sgamae dAudda —/e Date signal day,l lent- `.J ± 1
DSTRIstJT1ON:On,aal-Casty Audfa Fi, e-SleTWed Copy-Taxpayer
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