HomeMy WebLinkAboutHomestead_Blume CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
ei h STANDARD/SUPPLEMENTAL DEDUCTION FORM 20 1
rrt
� saw.^3 Form State 5473(R77/1-18) HOW _
Prescribed by the Departmental Local Government Finance
INSTRUCTIONS:See reverse side fortii ng instructions. Ste, /W.
� eNOTE:Telephone,Soc• _.:.a• 7•to idea i ircation and federal ident�calion numbers are confidential un r1C 6-f. \ -
:;ERTIFICATION STATEMENT
1 ) I5h LL1f(:� iii to l w te. certify that I(we)occupied as my(our)principal
lace o1`residence or am are bwino the following d=;- real property under contact for which a Homestead Property Tax Standard r
iertisli�FeDy'claimed on ute eaTeai -•....-- igned, (date of signature). I(We):
4Own. ❑ 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 on contract,Fee Simple owner's name
Recorders office wham contract is recorded DEG 0 2 2019 Record num•: Page
PROPERTY DESCRIPTION
County(•^ r Jl \J 1 3113�14NriT16 UN rY AUDITO'
Parcel number Legaldescripfion Is i•e,.ropertyinquestio•.
1 Real e prop 0 Annually assessed mobile home(!C 6-7.1-7)
If any portion of the residential structure or the land not exceeding one(1)ace that imm=•'ately surrounds.'if. • e is used to produce income,describe the use and portion
of the property utilized to produce income.
a 6 —1 cl— a— 1 0 ► --001 . 0 ki 1 —0 2—Li ,
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State,County,and Township Is claimant vacating a homestead?
0 Yes 0 No •
Si f d �D /e�
I hereby certify the above statements are true,correct and complete. �(/'
Address of contact numberand afr ay,state,and ZlPcode Address of vacated hom�,,iffa`y((numberand and ZIP code)
) any ,uy,
IO352 SISbf, i,tZ• :-3(1-11 r39
ASSESSOR USE ONLY I ASSESSED VALUE f !HOMESTEAD VALUE NON-RESIDENTIALRESDE
Land not exceeding one(1)acre Immediately 1
surrounding residential improvements (1)
Other land (2) ` ., ti :.
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(tine 3 pins line 7) (6)
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 -r of 60%of the assessed value of the homestead or$45,000.
Noiwithstandng an :r• on,the sum of the deductions provided in IC 6-1.1-12 to a mobile home $
rr
that is not assesse•- -al• .pe.perly onto a manufactured ho sessed as real property may
not exceed one-half 7r)of :assessed value of the mo ' home ormanuf d home.
Signature of Auditor 11) ;�\/�1 CYC Date 1g2d.(ram day,y
' LL .C7-� 'N1
DISTRIBUTION:Original-County Auditor,File-Stamped Copy-Taxpayer
Page 1 of 2