Homestead_Beasley (4) y. CLAIM FOR HOMESTEAD PROPERTY TAX a YEAR
-a ! STANDARD I SUPPLEMENTAL DEDUCTION FORM
a"Cr SlateForm 6a]3(RI?11-16) HC70 2019
'. Prescribed ty me DeoaNrem of Local Govenvcsm Finance
INSTRUCTIONS:See reverse side for filing instructions
NOTE:Telephone,Social Secunty,drivers license,state identification and federal identification numbers are confidential under IC 6-1.1-12-37.
' 'CERTIFICATION STATEMENT : _
I(We) tarry Ma, Beasley 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, BUNGS (date of signature). I(We):
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 . ..al si nc ,.
❑ Am(are) the shareholder, partner,or member of the entity that owns the property. \(y
Recorders office where centaa is retorted Record number Page
county - Township • • t Tams)clued(city town,township) . '
Gibson columbi a columbia
Pa2N number Legal descnp'asn Is the property in question:
26-13-11-30-oOl,360-OO6 C Real property 0 Annually assessea.maple home(IC 6-I.1-7)
If any portion of the residencel structure or the land not exceeding one(I)acre that Yrvnedutety surrounds that structure is used to produce income.describe the use and boron
of the property stared to produce income.
• PROPERTY OWNED ELSEWHERE BY CLAIMANT .
State,county.and Tovmseip Is claimant vacating a homestead?
Indiana, Gibson, Columbia o Yes ❑ No
Signature of claimant U
I hereby certify the above statements are true,correct,and complete. o 'clay�-ta•e, -
Address of contact(number and sheet c%slate,cut 2lP coact Address of vacated homestead,d any(number and street,sty..Cate,and ZlP code)
232 S 950 E, Oakland City IN 47660
ASSESSOR USE ONLY I ASSESSED VALUE I HOMESTEAD VALUE I NON-REALUE
SIDENTIAL
land not exceeding one(t)acre immediately I(1) I - -- - ' -„ I
surrounding residential improvements
I Other land I(2)
Total land(line 1 plus line 2) I(3)
Residential improvements or Dwelling 1(4) a
_ -
annually assessed mobile I - - -- -- -manufactured home Garage I(5)
_
Other improvements I(6) - I
Total improvements(line 4 through line 6) 1(7)
ITotal value (line 3 plus line 7) 1(8) I I
I hereby certify the above Is true,correct I signature of Assessor Date signed(yarn.day.year)
and complete.
decrying action-Signature of Asduor Date signed(moos.day.year
2skythinb7 7 a 09/04/19
STANDARD DEDUCTION ALLOWANCE •
20 pay 20 Lesser of 60%of the assessed value of the homestead or 545.000.
Notwrtnstandirg 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.
Signature of Author Date signed(.born,day Year
wS.e. 09/04/19
DISTRIBUTION: ongnal-county Audsor.File-Stamped copy-Taxpayer
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