Homestead_McAlister CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
,l •M,.. STANDARD/SUPPLEMENTAL DEDUCTION FORM _' -
`'� HCIO
�`-Jm�,^ State
Prescribed by the Departmental'Local Government Finance
INSTRUCTIONS:See reverse side for/lUng instructions.
NOTE:Telephone,Social Security,driver's license,state identification and federalidenlitica6on numbers am confidential under IC 6-1.1-12-37.
CERTIFICATION STATEMENT
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(We) ' i ry I nit-t` , i Shut certify that t(we)occupied as my(our)principal
place of residence or ar6(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, (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,1 partner,or member of the entity that owns the property.
Social Security number of claimant's spouse(last five dolts) Driver's license I fappli Identification's/o sec number of claimant's ci spouse(fast five digits) ' 5 ■ I♦
(Applicable aNyBappixard's spouse does not have a seder secuifty number) r■L��
CONTRACT RECORDED If buying on contract Fee Simple owner's name O C T 7 2049
Recorder's office where contract is recorded Recent number Page aI . N
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PROPERTY DESCRIPTION tJ OR
County J Tawnshl T district(city,town,township) - -
tbket_
Parcel number Legal description Is the property in question:
0 Real property 0 Annually assessed mobile home(IC 6-1.1-7)
If any porton of the residential structure or the land not exceeding one(1)acre that immediately surrounds that structure is used to produce income,describe the use and portion
of the property utilized to produce income,
2:6', /2.-04,- -,201 ill --003, e)/ - aze
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State,County,and Township Is claimant vacating a homestead'?
0 Yes ❑No •
Sign t of claimant ,"\C
I hereby certify the above statements are true,correct,and complete. A
:';L - A G
Address of contact(numberand sfree4 city,state,end ZIPPr ` i ted h'mestead,if any(number and sheet city,state,and ZIP code)
9a2 E9/it4/ A010 i kin 471070
ASSESSOR USE ONLY ( ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL
VALUE
Land notexceeding one(1)acre Immediately (�) r
surrounding residential improvements
Other land (2)
Total land(line 4 plus line 2) (3)
Residential improvements or Dwelling (4) t', 54 r
annually assessed mobile!
manufactured home Garage (5) rngkcg I.
Other improvements (6) .e. .1 -„j-.,..."
Total improvements(line 4 through line 6) (7)
Total value(line 3 plow line 7) (8)
I hereby certify the above is true,correct, Signature of Assessor Date signed(month,dad;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 provision,the sum of the deductions provided in IC 6-1.1-12 to a mobile home $
that is not assessed as real properly or to a manufactured home Thetis not assessed as real property may
not exceed one-hall(1/2)of the assessed value of the mobile home or manufactured home.
Sign f Auditor Date signed(month,day, al')
i
10/17 20/ 9
01S ON:Original-Co udder,File-Stamped Copy-Taxpa
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