HomeMy WebLinkAboutHomestead_Schmitt (9) .� ^•n CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
I STANDARD/SUPPLEMENTAL DEDUCTION FORM
a•\ i' State Form 5473(R17/1-16) HC10 2.019
,T Prescribed by the Department of Local Government Finance Q
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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.
CERTIFICATION STATEMENT
1.
I(We) Schmitt,Jordan T/Kelsey Jo certify that I(we)occupied as my(our)principal �0
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, (date of signature). I(We): �^
0 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.
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If buying on contract,Fee Simple owner's name
Pis
Recorders office where contract is recorded vii_LRecord number Page
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PROPERTY DESCRIPTION 1
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County Township Taxing district(city,town,town ip) 3
GIBBON UNION UNION •
Parcel number Legal description Is the property in que ti • -� \11;1;1.‘°g 1v_}
26-19-29-400-002.449-025 WI Real property ba ally 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 surrounds that f(F tarVsPusl`ed to produce income,describe the use and portion 1 1)
of the property utilized to produce income. Z ,�/
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PROPERTY OWNED ELSEWHERE BY CLAIMANT h
State,County,and Township 4S'Cteinmutwdt,t ?,,. M
❑ Yes No Ol M
SrgnarA ��..
I hereby certify the above statements are true,correct,and complete. «/ X
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Address of contact(number and street,city,state and ZIP code) Ad•j ss of vacated homestead,if any(number and street,city,state,and ZIP code) V
13&/ E 'SD t5 as ofaat,2 7 39 ---0
•
ASSESSOR USE ONLY I ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL � •
Land not exceeding one(1)acre immediately
surrounding residential improvements (1)
NI
Other land (2)
Total land(line 1 plus line 2) (3) tO
Residential improvements or ' Dwelling (4)
annually assessed mobile/
manufactured home Garage (5) ,
W`Nil e
Other improvements (6) Q `
Total improvements(line 4 through line 6) (7) a
Total value (line 3 plus line 7) (8)
I hereby certify the above is true,correct,
Signature of Assessor Date signed(month,day,year) �'s
and complete. — N.
.Signature of Aud t / Mile,4:11..i(yt , day y=r) ?.•
STANDARD DEDUCTION ALLOWANCE Q)
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�0�pay 20 Lesser of 60%of the assessed value of the homestead or$45,000. p
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 that is not assessed as real property may O
not exceed one-half(1/2)of the assessed value of the mobile home or manufactured home.
l,_.'.. 7ei /J res..month,day alp
DISTR ION:Original-Coun Auditor,File-Stamped Copy xpayer
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