Homestead_Whitehead •C f, CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
efran: STANDARD/SUPPLEMENTAL DEDUCTION Fad
HC70 zo t�
f, State Fare 56T!(Rat 1-16)
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nint Prescribed try an Department al Loral Government pa-ce
INSTRUCTIONS:See reverse side brhbg i bue:oru
NOTE-Telephone,Social Seaail%dyer's tense,state iderrabrion and laden/irkrrdcaton numbers we mn€deldml under IC 6-1.1-12-37.
I(WO , an\\€ �'l I I h \ certify that I(we)occupied as my(our)opal
place of residence or am(are) ding the following described real properly under contract for which a Homestead Property Tax Standard
action is hereby claimed al the date this application is signed, (date of sgnaNre). 1(Ne):
Oe El (are)buying under recorded contract
❑ (are) entitled to occupy as a tenant-stpddwwer of a cooperative causing corporation_
❑ Have a beneficial interest in the lost or the right to occupy the property under the terms of a qualified personal residence tout
❑ Am(are)the shareholder, partner,or member of the entity that owns the property.
name of (eve name)
(regalName d dears noose
J (e ,
SoaY Scanty
.• --'. .. .. ...r'... _ ., _.
If on attract,Fee Snobs canoes nano
Re:We a ohm wham cornett is recorded Read rumba Pepe
I PROPERTY DESCR PTION . . _ - _ ' ,
Canty Taeadsp Taub dseidp3y,men,Mendip)
_b
Patel=ter Leila duo ern p Ls On opemy aas5oa
❑Real pcpaiy 0 Avmyy assessed mobae nxee(IC 61.1-1)
m etry Paten re the residential manse a the lid not exersing as(1)mere mat nurmdaaNwanks the sums H used to produce name,mobile are m aid Paso.
a de property taxed b police inane.
1 '-ZR— y 00— 000 , —OC Ci
+- - I. -• ,` PROPERTY.OWNED ELSEWHERE BY ClAllnANT. _ - : - •T
rb S ,Can);ark Township• I3 da\q&nl varatlng a homestead?
Jry7���Yes ❑ No
Sipmre adamtm- /
I hereby certify the above statements a wpm(number Olstatements are true,
m correct,correct,and oomplefe. /r_� _ /) ^� -.S Address ( trr ee stab.end Z1Pm) a. tu,� (number ++C..ass6ecoce) ✓
s .I
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ASSESSOR USE ONLY _n I ASSESSED VALUE; 1.1,.. HOMESTEAD yALLT, •.,I. rtON RESIDENTIAL
VALUE
-::2
Land riot exceeding one(1)acre Immediately (1) 1. -Fi5<t2 rr ._F
sursoundmg residential improvements _ - .r.
Other land (2) 11+■■t��'�..aa••_ 3,k- ? - _
Total land(line 1 plus fine 2) (3) `J
Residential null essedemeds or Dwelling (4) _-- ___ _ _ _
annually assessed mobile I {{����77 yy I ((tt ((�� .`
manufactured home Garage (5) .-4 ,•e: :
¢ JUIV;:j Y 2U�JC
Other improvements (a) .: <-=.=-F't-'x -:d--stir:,'
Total improvements(line 4 dtroogfr line 6) CO
Total value Vine 3 plus fine T) (8) I tiring
I hereby certify the aboveHhue.carted, signers aAssessor GIBSUN COU s I Y AUDRItoRed nMh ddxwal
and complete.
Vedybg atom.Siouan otAxebs Date signed(smash,day non
;- _ - .I STANDARD DEDUCTION ALLOWANCE - _, _ ..
20 pay 20 Lesser of 609%of Me assessed vane of the homestead or$015,000.
NoMithstarrdrg any other provision,the sum of the deductions provided In IC 6-1.1-12 to a mobile home S •
that Is not assessed es real properly or to a manufactured home that is not assessed as real property may -
not exceed one-half(f/2)of the assessed value of the mobile home or maadarhned home. ,
Square aAr¢mr�'I. p (.. Oats zd rx,,, .
DISTRIDIIGOW Cecina-Corny Audsa.FieDaired Croy-Tanya ,.
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