HomeMy WebLinkAboutHomestead_Dickinson ,.. CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
c' �'p STANDARD/SUPPLEMENTAL DEDUCTION FORM
State Form 5473(R17/1-16) HCIO
Prescribed by the Departrnentof Local Government Finance
INSTRUCTIONS:See reverse side forfiing instructions.
NOTE Telephone,Social Security,driver's license,state identification and federal identiication numbers are confidential under IC 6-1.1-12-37.
CERTIFICATION STATEMENT
I(We) 1CkVA CI,— i 0 IL‘r\s®t1- 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
Dedu n is hereby claimed on the date this application is signed, (date of signature). I(We):❑ Am(are)buying under recorded contract.
fa
❑ Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation_
0 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.
CONTRACT RECORDED
If buying on contract,Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
PROPERTY DESCRIPTION
Coub2s,üm
To hip Taxing district(city,town,township) •
! in6U1 I L .
Parcel number Legal description Is the prat"dy in question:
property 0 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 surrounds that structure is used to produce income,describe the use and portion
of the property utilized to produce income.
CLO � I-7 - 1 -- 0I — CC°- IC
Dtz
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State,County,and Township Is claims g a homestead?
Yes ❑No •
Sign of claimant
I hereby certify the above statements are true,correct,and complete. 42R.�:2A- , nAr..1.€.14 4
Address of contact(number sheet;dty, and ZIP code) A�Address of vacated homestead,if any(number- -street, itty,state,and ZIP code)
ASSESSOR USE ONLY . ASSESSED VALUE HOMESTEAD VALUE NON- ESIDENTIAL
VAL
Land not exceeding one(1)acre immediately °
surrounding residential improvements (1)
Other land (2) , " ,.,. [
Total land(line 1 plus line 2) (3)
Residential improvements or Dwelling 9 (4) '3 y
annually assessed mobile!
manufactured home Garage (5) S _ x i
Other improvements (6) •
Total improvements(line 4 through fine 6) (7) r . -4wt. ovVOR
Total value(tine 3 pits line 7) (8) Cr/�y GOO"
I hereby certify the above le true,correct, Signature of Assessor :i:gnt�d{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 provision,the sum of the deductions provided in IC 6-1.1-12 to a mobile home $ •
that is not assessed as real property orb 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.
Sign re of Auditor - r('� L (Dataagned(rrrorrth,dal:11ye(1ar�)�
•
b1r� 1- .c ��\`
DISTRBUTION:Original-CountyAuddor,File-Stamped Copy-Taxpay
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