Homestead_Snodgrass i-. CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
4. •t STANDARD/SUPPLEMENTAL DEDUCTION FORM
r ��el
Form 6473(R1711-16) HC70
Ftesmum May the Celmmmd at trail Government Pomp
INSTRUCTIONS:See merge side for piling instnx ono
NOTE:Telephone,e,Social Secwdx driers Scent,state berr55ration and federal numbers are confider:al wider IC 6-1.1-12-37.
���l�� ) • CERTIFICATION STATEMENT -
•• I(We) � fl ISIVIIal �z Inn 3 I(we)ocajpied as my(era)Principal
place of residence or am(are)buying the .0, ' e d— -bed -••_ •under.• 4_1.for which a Homestead Property Tax Standard
ion• is hereby claimed m the date this application is signed. (date of signature). 1(VJe):
n ❑ Am(are)buying under rearded(are) entitled to occupy as a tenant-stockholder of a coopeiati.e housing corporation_
❑ Have a beneficial interest vi the that a the right to occupy the property under the terms of a qualified personal residence bust
❑ Am(are)the shareholder, partner, or member of the entity that owns the property.
Recorders ogeevhre meal is ramrod Record enter Page
`r -' - .I� .. . PROPERTY DESCRIPTIOV- .. - .°. •- -
Car4 heat p leing darkt(aM teem beta?)
_Race runner legal desapaon Is in question
eager 0 Avualy assessed mode tars(IC e-1.1-7)
uam paSi d the residwee shore ores bed net emee/enq ore(1)ere that mneiaYy sunbae is used to modem inmate destine,the use and pram
et the properly Wired t produce hraro.
2-
6 -Zo --27 _ boo - coo, 5-3 6 - oo I .
_- � ` _ 'PROPERTYOYINED ELSEWHERE BY CLAIv1ANT - 'b
SU°•may aN Torrishe Is dahmrt vacating a homestead?
0 Yes 0 No •
Crate!
I hereby certify the above statements are tole,correct,and complete. ikr
Adtress d mead(moteed stint oily,stab,and ZVPcede) Addre s a mated l...v ,deny(xa'nher ed stet,opt sate,end ZPmd)
gin sgsvI 1 JaiSii -- n -4�64`�- -
NOIJ-t2ESIDENTIAL
ASSESSOR USE.ONLY - '•ASSESSED VALUE,��, HOMESTEAD VALUE_ -, .,VALUE - '
surroundingLand not residential iing one mprovements acre b (1)tely I"lt a#'e ei rC
Other land T
Total land(lire 1 plus Ens 2) (3) t'I T E .I1) ..
Residential improvements or Dwelling (4) l y r ,.t& •ilil ;.'-
annually assessed motile I - r�
manufaeblred home Garage (5) uy� $ -=�.
Other improvements (6) AUG 7 2019^sA .
Total improvements(line 4 through line 6) (7)
Total value (the 3 pis line 7) (S) 9
I hereby certify the above true,correct Signt t `{ ON COUNTY AUDITOR Dated (m*MA day.man
and complete.
Vadyig emn-Waite of Aodsr Dam signed(mudA oat,leer)
20 pay 20 Lesser of 60%of the assessed value of the homestead or$45,000. .
Nolvehstandmg. ' • -r provision,the sum of the deductions proNded in IC 6-1.1-12 to a mobile home S
that is not sae- •a...property ono a manufactured home Natis rot assessed as realpmperty may
rotraceed. ..0 ( I ..Eo astssetl vatrmwrromdazbred home.
a Date
aMIT mg)
OsiRID1/11Wl:Ongra- ,,,AA
.Fie-Slartdtl Copy- am»'a IF/.
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