HomeMy WebLinkAboutHomestead_Bolden (2) l.. CLAIM FOR HOMESTEAD PRSPE9M TAX YEAR
l STANDARD/SUPPLEMENTAL DEDUCTION FORM
____-^' 6me Fan 5473(R17l 1-16) HC10
Prescribed by the Department rf Loral Government Finance
INSTRUCTIONS:See reverse side for fling instructions.
NOTE Telephone,Sodal Secwi4 dniets items,store' 64rLdcalion and federalIdertffica5nr numbers are contdereiai under IC 61.1-12-
I(We) • certify that I(we)occupied as my(our) •
.
place of residence or am(are) the following desrnriihed real property under cont T S contract far which a Homestead PropertyStandard
Deduction is hereby claimed on the date this application is signed, (date of signature). '.' O
12 c/ant 0 Am(are)buying under recorded contract ` 2019
❑ Am(are) entitled to occupy as a tenant-stockholder of a cooperative housing corporation.
❑ Have a beneficial interest in the(rust or the right to occupy the property under the terms of a qualified "
lelaly s
❑ Am(are)the shareholder, partner,or member of the entity that owns the property. N
CO iAr ,
Nae d Gsma(MCY name) a
Sods Sanity amber d duds spouse Sat Use thgas) Ceres soW*r ldadeceio,fete=ter of darns,ipaee past the dgnt) 1141g Sale
(AApr®tle on1'f anaemia's spa does not Me a scrial:nasty darter)
•
tbuying on=Ctl.Fee Sink masses rare
Recorder's dace Wine comma is recalled Rand nutter Page
Comfy Toms)*- - - - ~PROPERTY-0E�(i/1o"y1PTIOLY
Pacelrrmbm legs desat1 Is to •n geeatet
pJ• es pcwaiy 0 Amu*assessed nose hie(IC 61.1-7)
If cry paten of the ret®Eas satn a Ireland not emceed rag me(1)are to tnedia5y=rands that saucers s used to gradce ixxxm,desalt*to me wad paten
d to ptcaty tithed to pmdsce ismne.
at• - 1L - \8 - 30a--off 3-\S- ( Di-7
•
PROPERTYOV,NEDELSEWHERE BY CCAIMAhT - c.•- y, .
Sam,Gassy,ad Toemship Is claimant vacatng a homestead?
❑ Yes ❑ No '
I hereby certify the above slatemmis are true,correct,and complete. Addy Address d m esatact(rxn l ei syay,db:"•••e,and ZDcond) raved a,aay(nmmeran sties,aiy,state,end ZIP coda)
Po N. Nt -n 0 I , e,, b,.
ASSESSOR USE ONLY -.' ii ASSESSED rLUE'!vlr.7,HOHESTEAD VALUE -.i�' fOr-.RESIDENTIAL
Land not exceeding one(d)ame Immediately (t) i�,. �,f- x _.y
ndmg residential improvements = .
Other land (2) ._...Ts..._ A1-
..c....4._ —
Tata)land(line 1 plus fine 2) (3)
Residential improvements or Dwelling (4) al� ter"
annually assessed mobile I 'l -- =
manufactured home Garage (5) ,yr ,s-:_ `
Other improvements (6) '{'L� .3.-.'4"1 Q. `,l�\ 1/ . /
Total bnpeavements Pine 4 mrough fine 6) (T) �K` 4 _is s°ck OR
•Total value Vine 3 plus line T) (S) •� '( N
I hereby certify the above is true,correct, Signature of Assessor Da- .-:1 ,(•� •Y'.lav7
r(1N
Verifying
mem-Sam a e Auer= 'l`god(meth,dry,lead
STANDARD DEDUCTION ALLOWANCE -n6 i -
20_Pay 20 Lesser of 60%of the assessed value of the homestead or 545,000.
Notwithstanding any other provision,the sum of the deductions provided in IC 6-1.1-12 to a mobile home $
mat is not assessed es real properly or to a manufactured home that is not assessed as real popery may
not exceed one-hat(f/Q al the Vail of the mobile borne or narafa[aaed?nne.
S%n. �avEb V ^ Daze signed(nm+A d9;pen
DlSmWBUmION:Or9te-Cos Ail,,Re-Seeped espy-Taxpayer
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