HomeMy WebLinkAboutHomestead_Holder CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
eta 1 STANDARD / SUPPLEMENTAL DEDUCTION FORM
\\� f Sate Form 5473(R21 /7-25) HC10 - '
"-- Prescribed by the Department of Local Government Finance ! '
INSTRUCTIONS:See reverse side for filing instructions.
NOTE: Telephone. Social Security. driver's license, state identification and federal identification numbers are confident I u d: IC 1.1- :7.
CERTIFICATION STATEMENT
i
I (We) ,, . ' certify that I (we)occupied as my(our)principal place of
residence or am(are)buying r6ong 'bed71,4xopertyunder contract for which a Homestead Property Tax Standard [Je4n 9 tebed on the
date this application is signed, (date of signature). I (We)- J N'v J �JL U
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 res. t ..---7 2dJ
❑Ain (are)the shareholder, partner, or member of the entity that owns the property. : s , a
' . . III . .
Recorders Office Where Contract is Recorded Record Number Page
PROPERTY DESCRIPTION
County Township (.0 u i__ Taxing Di ct(cry, t wn, township) cParcel Number Legal Description Is the pewin question
Real Property Ei Annual ssessed Mobile Home(IC 6-1.1-7)
if any portion of the residential structure or the land not exceeding one(1)acre that immediately surrounds that structure is used to produce income,descnbe the use and portion
of the property utilized to produce income
016 ( /-i 6 - io (/ - 000. / 7 s _ l20 7
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State County Township Is Claimant Vacating a • .40, -•?
❑Yes `.•J .
ignature of Claimant ----milk
I hereby certify the above statements are true, correct, and complete.
tISUIPall (eAktitlii.
Address of Contact(number and feet city state, and ZIP code) A ress of Vacated Homestead.if arty(number and street.city, state. and ZIP code)
1c . I i) . ,(/ O �, 7 G D
ASSESSOR USE ONLY ' ,..SSESSED VALUE HOMESTEAD VALUE NON RESIDENTIAL VALUE
Land Not Exceeding One(1)Acre Immediately (1)
Surrounding Residential Improvement
Other Land (2)
Total Land (Line 1 plus Line 2) (3)
Residential Improvements or Dwelling (4)
Annually Assessed Mobile I
Manufactured Home Garage (5)
•
Other Improvements (6)
Total Improvements (Line 4 through Line 6) (7)
Total Value(Line 3 plus Line 7) (8)
Signature of Assessor Date Signed (date. month,year)
I hereby certify the above is true, correct, and complete.
Verifying Action-Signature of Auditor Date Signed (dare,month, year)
STANDARD DEDUCTION ALLOWANCE
For assessment dates after December 31, 2024:in 2025.
20 Pay 20 S48.000. in 2026, $40,000: in 2027, S30,000: in 2028. S20.000.
in 2029, S10.000; and beginning with the 2030 assessment date
and for each assessment date thereafter.$0.
Notwithstanding any other provision. the sum of the deductions provided in iC 6-1.1-12 to a $
mobile home 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. \
Z/LI \
Signature of AiEitor 's Date Signed(month. (fey,yew) \\
DISTRIBUTION: Original-County Auditor,File-Stamped Copy-Taxpa r
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