Homestead_Hale (4) •
CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
, 1 STANDARD/SUPPLEMENTAL DEDUCTION FORM
4HC70iJ State Fonnun(Rn/1-I6)
2019
Prtsmbed ty use Detainment of Local Govenment FW nce
INSTRUCTIONS:See reverse side for Ong instructions
NOTE:Telephone,Soria/Secunty,dnveis license,state identhcabon and federal idenbfication numbers are confidential under IC 6-1.1-12-37.
-,r I' ) �. •CERTIFICATION STATEMENT. c_ d.' s r' y - ,
I(We) Beth 6 Andrew Hale 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, 7,3112019 (date of signature). I(We):
0 Own. ❑ Arts(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.
Name W clamant(legal name) Telephone number of W'vvnt
Andrew Hale ( )
Beth Hale
-
If burying on tensed.Fee sense comers name
Recorders oboe where contract is recorded Record number Page
County Township Taxing district(ry.town.township)distnd(ofy.torn,township)
Gibson Patoka Twsp Q
Par trousber Legal description property inption Is thedoeskin: �I1 LL 3 1 203
•'
o Real property 0 Annually assessed rno�lee home BC 64
B any porton of the residental structure or the land not eaceedvp one(I)acre that immediately ediatey surrounds that sauce/it is used to produce noon,desmx the use and po
n of the to Produce mono e.the pro
26-12-03-200-001.447-027 G(gSON COUNTY AUU(TOR
- r) PROPERTY OWNED ELSEWHERE BY CLAIMANT:.........•.. -.. ' -
State,County,and Tovms oP Is claimant vacating a homestead?
❑ Yes Q No
Signature of claimant
I hereby certify the above statements are true,correct,and complete. g ,/F .//
Atrxess of contact(number end ebeee,cby,mate,and ZIP code) Address of vacated homestead,if any(numberand stint.cry.matt end ZIP code)
2862 E 100 N Princeton , IN 47670
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.: n ASSESSOR USE ONLY '.` - I ASSESSED VALUE --I- HOMESTEAD VALUE r I N ON RESIDENTIAL
•
Land not exceeding one(1)acre immediately 111 - -
-
surrounding residential Improvements
Other land (2)
Total land(line 1 plus line 2) (3)
Residential Improvements or Dwelling (4) •
annually assessed mobile
manufactured home Garage (5)
Other Improvements (6) , . _ - ._.
Total improvements(line 4 through line 6) (T)
Total value (line 3 plus line 7) (8)
I hereby certify the above is true,correct, Signature of Assessor Dora signed yawn say Pearl
and complete.
Vriyup action-Signature of Auditor Date Signed(month,day year)
-. .• .4`r 1.. _ - - . STANDARD DEDUCTION ALLOWANCE' - . _.. r. .
20 pay 20 Lesser of 60%of the assessed value of the homestead or S45,000.
Notwithstanding any other provision,the sum of the deductions provided in IC 6-1.1-12 to a mobile home S
that is not assessed as real property or to a manufactured home that is not assessed as real property may
not exceed one-half(1/2)of the assessed value of the mobile home or manufactured home.
Sputum of Auditor Date signed(moeh,day year/.,,?f- 07-31-19
DISTRIBUTION:Otgeal-County Auditor.FieSarrpad Copy-Taxpayer
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