HomeMy WebLinkAboutHomestead_Ziller (2) CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
„.14 STANDARD/SUPPLEMENTAL DEDUCTION FORM
•—•�re T�� State Form 5473(R17/1-16) 14010
Prescribed by the DepartmentalLoral Government Finance •
INSTRUCTIONS:See reverse side for filing instructions.
NOTE Telephone,Social Security,driver's license,state identification and federal identification numbers am confidential under IC 6-1.1-12-37.
11��� CERTIFICATION STATEMENT
1(We,1�,`�wlr/LMa1 ' 1 certify that I(we)occupied as my(our)principal
place of residence or. (are)buying the fo o 'ng described real property under contract for which a Homestead Property Tax Standard
Deduction�`ff is hereby claimed on the date this application is signed, (date of signature). I(We):
AOwn. ❑ Am(are)buying under recorded contract
/[] (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.
CLAIMANTS INFORMATION
-•
(Appricable only ifappr•: a•ouse does not have a social security number.)
CONTRACT PECOR'_•ED
If buying on contract.Fee Simple owner's name - -eintt :IW
Recorder's office where contract is recorded SEP 2 0 2019 rt Record number Page
PROPERTY DESCRIPTION
n riTir-.
County Township T-i '�r3jji/}yyl►i p)
GIE • : I IISI"tt-I_ OR
Parcel number Legal description Is roperty in question:
J Real property ID Annually assessed mobile home(IC 6-1.1-7)
If any portion of the residential structure or the land not exceeding one(1)acre that immediately s ands at structure is used to produce Income,describe the use and portion
of the property utilized to produce income.
L \ -\2- -)O4Oo3
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State,County,and Township Is claimant vacating a homestead?
0 Yes ❑No •
)(Sitar claimant
I hereby certify the above statements are true,correct,and complete.
i�
Address of contact(numberendsbui-4 city,state,end ZIP code) Address of vacated h estead,if any(number and street,city,state,and ZIP co
•
I
I
ASSESSOR USE ONLY ; ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL
I VALUE
Land not exceeding one(1)acre Immediately
surrounding residential improvements (1) y...: _:,:f,. .,._._...
Other land (2) . .z l,_;i `. .z
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 prta line 7) (8)
I hereby certify the above is true,correct, Signature of Assessor Date signed(month,day,year)
and complete.
Verifying action-Signature of Auditor Date signed(month,day,year)
STANDARD DEDUCTION ALLOWANCE
20 pay 20 Lesser of 60%of the assessed value of the homestead or$45,000.
Notwithstanding any other•mvfsion,the sum of the deductions provided in IC 6-1.1-12 to a mobile home $ •
that is not assesse• -. •roped),or to a manufactured home that is not assessed as real properly may
not exceed one-ha, ••the assessed value of the mobile ho anufactured home.
Signature ofAudtor '. Date signed( nth,day, 0 .
-1\A'.\\I 6.''''.%
DISTRIBUTION:Original- •1 Auditor,File-Stamped Copy-Taxpdytrr'
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