HomeMy WebLinkAboutHomestead_Snow 2. CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
' STANDARD/SUPPLEMENTAL DEDUCTION FORM �
ilk arm m 5473(R17/1-16) RC10 "_■_
'b Prescribed by the D'epamnatof Lod Einn® ■
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INSTRUCTIONS:See reverse side for bong instructions.
NOTE Telephone,Social Securitx drivers license,state ax,LITtofun and federalldejVdeab'on numbers am wm fderfial under IC 6-1.1-12-37.
CERTIFICATION STATEMENT
)(we) p 1/40.11 l 44 "Ca. 3nl7va certify that I(we)occupied as my(our)principal
place of residence or am(am)buying the fomwing described real property under contract for which a Homestead Property Tax Standard
action is hereby claimed on the date this application is signed, (dale of signature). I(We):Own. ❑ Am(are)buying under recorded contract
❑ (are)entitled to oo ipulb y as atenant-stockholder of a coopela housing wrporetion.
❑ Have a beneficial interest in the trust or the right to moldy the property under the terms of a q afified personal residence trust
❑ Am(are)the shareholder, partner,or member of the entity that owns the property.
.. Ii _ CLAIMANT'S INFORt.1AT10N _ .. -- - .
Name of clamant(legal neva),
-
TNs-a k_ `Smog . ,
Saidseaarn'nmmertl spase(faslfve.Lges) ..„.....
-;•- •-_ ffiNyramaa-J
r; . - _ .''CONTRACT RECORDED
t txry6sp cn inner;Fro&mkt owners naro 11 3 2019
Remt's ohs Wine cortais recorded Rend number Page
/, , • e-sr��e�e/
Carey , TOAssNp Tarter dsaid(olY,bast r &f
Pad anthem Swl Legal dacpbi Is in question
Real property ❑Annually assessed made tone(IC si.1-7)
If arty portion of the resiemal structure ores lannddd not exceeding ow(I)ace tat immediately saucers
sauersrts used to produce room e,,ddesmte�t+e(,use
�/Iaid palm
a the property lnT¢eampRfFco:ssoe� V 2 — \0 —CD C.� . 12
- JOJ�/1\i. T " _ _ :PR/O/PPPEERTYTY`\OWNED ELSEWHERE BY CLAIMANT- _ I.- _ 5.., .
&,Cody.and Township Is claimant vacating a homestead?
❑-Yes 0 No
Signhxe of chimera
I hereby certify the above statements are true,caned,and complete. .. i'r'a -^� , ,
Address of oadat(number and street,dr%,taro,and ZIP code) of vacatedhemostat,drany(number end street,c.;stare,end ZIP cod)
$_fit{ & Li 10 W 0 l-c( 1)e .
- _ ASSESSOR USE ONLY A�) SSE D VALU SS E �I`,Q NOHESTE D VALUE;::t NOt --RE LIUENTIAC /
Land not exceeding one(1)acre immediately --Y, -
surloundmgresiderdialhmprovernents (1)
Other land (2)
Total land(line I plus line 2) (3) ..-
n
Residential improvements or Dwelling (4) ?
annually assessed mobile/
manufactured home Garage (5) ,_'_ _, . --_.._
Other improvements (6) 'r' E. r --.-._."
Total improvements(fine 4 through line 6) (7)
Total value (line 3 plus fine 7) (6)
I hereby certify the above is true,correct SFgra3ue ofM,aceor Dar'sighed(rnaen,my;yea)
and complete.
Vety6g action-crft^m of Ault( Date sig ed(mean day;lea)
_ -, -' . -- — r.T: _ .. .. v. _
-.4. - r `,`'_� STANDARD DEDUCTIOFJ ALLOINAIJCE, '" - "
20 pay 20 Lesser m 60%of the assessed vane of the homestead or E45.000.
Notsith dv stang any the sum of the deductions provided in IC 6-1.1-12 t a mobile home $
Oatisrotassessed•- . .. perry or to a manufactured home that is not assessed as real properly may
not exceed one-half( ' of assessed value of the mobile home manufa ,.r=. ,.. -
Date sirtoil
aigabrenfNidbn e,�,�, Ci,. (^ 1 1 11 n
J ` I{
DtSTRIa11TFON:Ongval-Casty Audda,fps Stamped Copy-Taxpayer
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