Homestead_Warren CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
1 STANDARD I SUPPLEMENTAL DEDUCTION FORM
7 State Form 573(R17I1-16) HCTD
%' Prescribed ty me Department of Local Government
ane
INSTRUCTIONS:See reverse side for filing instructions.
NOTE:Telephone,Social Security,divers license,state identfication and federal identification numbers are confidential under IC 6-1.1-12-37.
_ j., ... CERTFICARON STATEMENT. _
I(We) Pasha&David Warren certify that I(we)occupied as my(our)principal
place of residence or am(are)buying the following described real property under contract for which a Homestead Property Tax Standard '
Deduction is hereby claimed on the date this application is signed, 712612015 (date of signature). I(We):
O Own. ❑ 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 qualified personal residence trust.
❑ Am(are) the shareholder, partner,or member of the entity that owns the property.
' ` - �CLAIMAN7•S1NFORMA71oN ; :,y - -Name of claimant(legal name) 1 • Telephone number of claimant
David Warren ( )
-
Alisha Goebel Warren
Sooal dgas) Drivers Kens.I Identification/Other nurturer of claimant's spouse(last five Cgts) Isaung State
(
` ♦' '�,h 'CONTRACT RECORDED . . _ _ .n _.
Ifbuying on Corinth.Fee Surple owners name-
Recorders office where con:ntl is recorded Record number Page
County } Township i T rag I Wig( 31.1.712,
-
gibson
Parcel taunter Legal description -Is me property in questan
II I� {,A '11V�lQ�perY ❑ Annua%assessed noble home(IC IiI.1-7)
any potion of the reeEental structure or the land not enceedeg one(1)acre that umadi'.CJ ienoad■ aa4Glre is used to produce income,describe the use and poison
of the popeny utdzed m produce income.
26-13-18-403-000.135-005 n '
•. •
° • J _ PROPERTYOWNED ELSEWHERE BY CLAIMANT � v
State.County.and township Is claimant vacating a homestead?
❑ Yes IL) No
Signature of claimant
I hereby certify the above statements are true,correct,and complete.
Atlfress of comatl(number and edem,cay sate,and ZIP code) Address of vacated homestead.if any(number and Meet ay,rate,end DP meet'
6100 E SR 64 Francisco , IN 47649
ASSESSOR USE ONLY' ).tv I ASSESSED VALUE' fri.' JHOMESTEADVALUE sI,-_r" NON-RIEIuDEENTIAL
Land not exceeding one(I)acre Immediately 11) - -
surrounding residential improvements
Other land (2) _ •
Total land(line 1 plus line 2) (3)
Residential improvements or Dwelling (4) .
annually assessed mobile l - -
manufactured home Garage (5) -
Other improvements (6) .
Total improvements(line 4 through line 6) (7)
Total value (line 3 plus line 7) (8)
I hereby certify the above is true.correct, I Signature of Assessor Date signed(mouth,day year)
and complete.
Ve 5'ing action-Signature of Audio, �pp Dab signedl(mo ,day.year)
n }3,r
e m. . _ ={STANDARD DEDUCTION ALLOWANCE 4, 3'- .„%)$` ' :
20 pay 20 Lesser of 6096 of the assessed vtue of the homestead or$45,000.
Notwithstanding any other provision,the sum of the dedlxawrs provided in IC 6-1.1-12 to a mobile home $
fiat is not assessed as real property or to a manufactured home that is not assessed as real property may
not exceed one-hall(1/2)of the assessed value of the mobile home or manufactured home.
Signature of Auditor Date signed(month day.yeas
7/26/2019
DISTRIBUTION: ongnal-County Auditor.Fie-Stamped Copy-Tamayer
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