HomeMy WebLinkAboutHomestead_Patterson � k CLAIM FOR HOMESTEAD PROPERTY TAX FORM
YEAR
STANDARD/SUPPLEMENTAL DEDUCTION
Stab Fan 5473(R17I 1-16) HC10 20\ 1 •
Prescribed by me oel atnaa of total Government Finance
INSTRUCTIONS:See'even.side tar Sop instructions.
NOTE Telephone,Social Seorn%drivers icense,sl te_iderrt5ca5m and lederandentfficafron numbers are ra,fldenfIa!under IC 6-1.1-12-37.
CERTIFICATION STATEMENT - - -
I Mt)
• am(areg 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, (date of signature). I(We):
XOwn 0 Am(are)buying under recorded contact
❑ Am(are) entitled to occupy as a tenant-stockholder of a cooperative housing corporation.
❑ Have a beneficial interest in the bust or the right to occupy the property under the terms of a quafrfied personal residence trust
❑ Am(are)the shareholder, partner,or member of the entity that owns the property.
._ ) .
`CONTRACT RECORDED - - - ,
If terig on mnaa.Fee Sins*amen rare
AUG 5 - 2019
Remras's ogee bite=tract is recorded Rend at Page
a� el
a _ PROPERTY DESCRIPTION�- x�• r� _: 1
Coady (_�\ ^ - Twang T:.. e-....r.-.-., =. vsr Y AUDITOR .
Parma I93 ,� Lagal dasatpan la Roan it msmat .
�,J Real Pr teeny ❑Aveaty assessed mcbte haw(IC 611-7)
tf nary pntiata the residential numre or the lap not ecceecky one(I)acre that immediately structure is used to produce(=me,dame the use and pain
of the an:perry Laced to prodxe irate
2G , X -2to -oOZ - i3B •
-oz
-PROPERTY OWNED ELSEIYHERE BY-CLAIMART .-. _.. .. ... .
SSe-Cary,a=M Twrstte Is claimant vacating a homestead?
CI Yes 0 No
darnel
I hereby certify the above statema,s are tie,correct and complete.
Address aeearm(numleer.lsteel,may.nee.and Encode) Aches al vacated aam(number end street,ay.me.wzhoims.)
43L\ . E 120 O s, ta(,,L, - 3r\
ASSESSOR USE ONLY AS5ESSEDVALUE : _ HOMESTEAD VALUE :.Ire' NONRESIDENTIAL —
Lan not exceeding one(I)acre Immediately (1)
surrounding residential improvement -.. •,.,
} ;
Other land (2)
Total land(line 1 plus line 2) (3)
Residential Improvement or I Dwelling (4)
annually asSeteed mobile I
manufactured Roma Garage (5)
Other improvements (6)
Total improvements(lime 4 through line 6) (7)
Toll value (Thee 3 pits erne+) (0)
I hereby certify the above is true,correct, Suistre ctMseser Dee signed(t tt decree)
and complete.
Verifying action-Signature dAudar Dam signed(math day.fear)
- ` _ - - _ STANDARD DEDUCTION ALLOWANCE'.'. - -
20_pay20 Lesser of 60%of the assessed value of the homestead or$45.000.
Nutt' any other provision,the sum of the deductions provided in IC 61.f-12 toe mobile home $ •
that is not a al property or to a manufactured home that is not assessed as real property may S
!Of aICMd ( Of ET'7Tnr=. r... =w�((
a�ae dMrab Date Vtt
1
RSTRIDIIi1ON:Origrel-CoveyA&rga.FieS aead Coy-Taryeya
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