Homestead_Warren CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
� a- STANDARD/SUPPLEMENTAL DEDUCTION FORM /-� /�
1- State Form 6aA(RII Mel
HC10 Loi9 r. Prescribed by the Department of Local Goverment Finance
INSTRUCTIONS:See reverse side for filing ins:ructons.
NOTE:Telephone,Social Severity,dnvers license,stare idens5caton and federal rden kadon numbers are wn.5dendal under IC 6-1.1.12-37.
,tF' ; , I, •CERTIFICATION STATEMENT. _
I(We) Brandon Warren 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, 09/06/2019 (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 personal residence trust.
❑ Am(are) the shareholder, partner,or member of the entity that owns the property.
- ,
If buying co content Fee Sipple comers name 6
209
Recorders ofce where corasa is recalled Record cancer Page
.4LL
m carry h* PROPERTY DESCRIPTION - - '.+_'n1-7• pR
cay Tartis Tams dwae Tarr. en township) IM" -`�( I;V#
04
Gibson Montgomery Owensvilleor � ON CO
Parcel Mintier Legal description is the propery AlAlguest": G15S
26-18-07-101-000.570-022 0 Real property ❑Annually assessedmomeborneQe6I.1-n
It any paoon of me 2stlenml esucane or the land not exceeding one(I)arse that iraredaof surrounds that st oorre is used to produce income,describe the use and porton
of the property utbaed to produce income.
I PROPERTY OWNED ELSEWHERE BY CLAIMANT
Sate,County.and Townrtp Is claimant vacating a homestead?
❑ Yes ❑ No
7" nun torn ant,
I hereby certify the above statements are true,correct,and complete.
�7
Address of coma(numbering avet cry state,and LP cede) Address of vacated lomeread steer lay,lire,and ZIP code)
406 E Clark ST., OWENSVILLE IN 47665
ASSESSOR USE ONLY I ASSESSED VALUE I HOMESTEAD VALUE .NON-RESIDENTIAL
VALUE
Land not exceeding one(1)acre immediately (t) -
surrounding residential improvements
Other land (2) -
Total land(line 1 plus line 2) (3)
Residential improvements or 1 Dwelling (4)
annually assessed mobile I - - -
manufactured home Garage (5) .
Other improvements (6) .
Total improvements(line 4 through line 6) (T)
Total value (line 3 pica line 7) (6)
I hereby certify the above is true,correct, Signature of Assessor Dal signed(mats,day read
and complete.
Verifying loon-Signature of Audca Date signed(moans day year)
' 1 -STANDARD DEDUCTION ALLOWANCE - _ - -
20 pay 20 Lesser of 60%of the assessed value of the homestead Cr$45,000.
NoMtthsanditg any other provision,the sum of the deductions provided in IC 6-1.1-12 to a mobile home 6
that is not assessed as real property or to a manufactured home that is not assessed as real property may
not exceed one-has'(Irz)of the assessed value of the monde home or manufactured home.
c slg2a2 es Aud/[or�` Gala signed -daayy1 e1ao3 i 9
GCS T[tl&ITOyI.Orgnt-Carey/wdiur,Fie-Stamped Co stayer
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