Homestead_Nixon e 'e, CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
e = STANDARD/SUPPLEMENTAL DEDUCTION FORM
�•
State Form 5473(R17/1-16) 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 confidential under IC 6-1.1-12-37.
CERTIFICAl1ON STATEMENT
I(We) Charles B.&Nora Nixon 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, 10/28/19 (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.
Recorder's office where contract is recorded Record number Page
PROPERTY DESCRIPTION
County Township Taxing district(city,town,township) r
Center
Parcel number Legal description Is the property in question: �p
26-12-12-300-000.745-004 ❑Real property 0 Annually assessed mobile home(1 •
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,describe fei/13�nd portion �t
of the property utilized to produce income. s.I
Gieso e eo„
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State,County,and Township Is claimant vacating a ho r r:
❑■
'leftsYes ❑ No (J
Signature of claimant TOR
I hereby certify the above statements are true,correct,and complete. '1
Address of contact(number and street,city,state,and ZIP code) Address of vacated homestead,if any(number and street,city,state,and ZIP code)
12 S 450 E, Princeton, IN 908 E Evans St., Princeton
ASSESSOR USE ONLY I ASSESSED VALUE HOMESTEAD VALUE NON-RESI
DENTIAL
VALU
Land not exceeding one(1)acre immediately (1)
surrounding residential improvements
Other land (2)
Total land(line 1 plus line 2) (3)
Residential improvements or Dwelling (4)
annually assessed mobile/
manufactured home Garage (5)
Other improvements (6)
Total improvements(line 4 through line 6) (7)
Total value (line 3 plus 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)
;, /tom 10/28/19
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 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 Auditor Date signed(month,day,year)
10/28/19
DISTRIBUTION:Original-County Auditor,File-Stamped Copy-Taxpayer
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