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Homestead_Davis (19) 3; CLAIM FOR HOMESTEAD PROPERTY TAX I� P�RIN YEAR ,c STANDARD 1 SUPPLEMENTAL DEDUCTION , See Fam5473(RITI 1-16) HCIO MOPrinted 19 ire Oe:aanas 0Lnm Covertnles r-.a>8 INSTRUCTIONS:See'evens side for fag instructions. NOTE'Telephone.Roth(Seaaf()S divers kenos,state idea-aka:on and federal lda: warn numbels are mrdd•ital under IC 6-1.1-12-37. ' • I(lave) l . e certify that I(we)ocapied as my(our)principal place of • ence or am(are)buying the described real property under contact for which a Homestead Property Tax Standard udion is hereby claimed on the date this application is signed, (data of signature). I(We): Own.ut ❑ Am(am)buying under recorded contrail. (are) entitledto occupy as a tenant-stockholder of a cooperative housing corporation. ❑ Have a beneficial interest hi the trust or the right to occupy the property under the terms of a queefied personal residence trust ❑ Am(are)the shareholder, partner,or member of the entity that owns the property. - CLAIl.1ANT'S INEORR1AilON -, ., - - - . Nana of throat( Sold Seeley renter a decrees spouseVase be cape) Other's sea*I Idavifial=I OTr nartee d thermoses space clan are clods) Issuing Sate (Alpeatie atyaepprsafa spouse does cot haw a social scatty meiler) CONTRACT RECORDED - _. If bt S on mead.Fee Sepia owners net. Recorder's ass'elwe=tract is Meadad Rend number Page -_- PROPERTY DESCRIPTION - _ _ _ .. Carey T .To.+ahp p Taping dstdd(dhi loan,da'mttp) Pane nrnber�\V� V A ' ," °"TI l J la .Ann Real arpety ❑Arne%assessed mote tens(IC 6-1.1-n If arty portion a to residential sduere a the laid rice eaitt'gare(1)doe that umetaay s�anstre is weds,seduce'vmn desame en we and pawn of Ile properly tatted to ornate be ne at-l+ -3`).- too - 00o ..131i -02- 1. - -: � '_. PROPERTY OYiNED ELSEYJHEREBYCDAIAtANi y - _,,.- .,� ,4 ea.S Carraid y, Township le davnant vacating a homestead'? 0 Yes ❑.No I hereby certify the above statements are tam,correct and complete. ' Alan° ee0.— ' Address a refract mum at steer diy.sne and ZlPmde) or tooled • Venda stt, saIP ) q z - s 0 ricLe end Z . ASSESSOR USE ONLY _ I cc,ASSESSED VALUE 4aI ,HOAIESTE D VALUE_.,-I NC t RESIUENTItl91, t.. l &e7 Land not exceeding one(1)acre immediately ltl h+'•`R 3e - S surrounding residential dnprorernenb � • Other land (2) TT � Total land(lire I plus line 2) (3) - f, pp pp nip .K _. • Ylr i annuallyResidential al improvementsssad or O•'•mrg (4) APR 1,V L019- r manufactured assessed mobile/ (S) L`s- --.L� r . manufactured home Garage Other improvements (6) d "" r>-. Total improvements(line 4 through line 6) m /`^•rt'^'y^�"" Tow value pmedvta�en �) bIUSON COUNT" AUDITOR I hereby certify the above is true,correct, Scream OL t.e error Data signed(nxrd,day,lea) and complete. Verifying aeon-SIPsare tAuda Dare siuee(rein,day fear) _ - " - - _ -=-o- �. • - .• ,w _ r'._ _ -STANDARD DEDUCTION ALLOWANCE 1 . ,- . r. 20 pay 20 Lasser of 60%of the assessed value of the homestead or$45,000. . Abhsdhstendl g any other provision,the sum of the deductions pmvld_-din IC 6-1.1-12 a a mobile home S that is not assessed as real property or to a manufactured home that is not assessed as teal property may not exceed one-hat(112)of the assessed value of the mobile home or home. G ORymallnOl'1:Original-CmtYPadda.Etc Salped Copy-Ta x payer Y^wasc` `1,•r, Page 1 of 2