Homestead_Hunt (19) e 'e. CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
1' ' ,t STANDARD/SUPPLEMENTAL DEDUCTION FORM -
`IS' State Form 5473(R17/1-16) HC10 2019
' 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.
CERTIFICATION STATEMENT
I(We)
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, 12/4/19 (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.
Name of claimant's spouse(legal name)
Social Security number of claimant's spouse(last five digits) Driver's license/Identification I Other number of claimant's spouse(last rive digits) Issuing State
(Applicable only if applicant's spouse does not have a social security number.)
CONTRACT RECORDED
If buying on contract,Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
PROPERTY DESCRIPTION
County Township Taxing district(city,town,township)
Princeton FIL . -: ;-t
Parcel number Legal description Is the property in question:
26-12-07-304-001.021-028 Q Real 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,11�tt2ulan196D961r
of the property utilized to produce income. IJ L LLUU I JJ
i . -
PROPERTY OWNED ELSEWHERE BY CLAIMANT OR
State.County,and Township Is claimant vacating a homestead?
❑ Yes • No
Signature of claimant
I hereby certify the above statements are true,correct,and complete. d,/J�,/6 er
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)
230 W Pinkney St., Princeton, IN 47670
ASSESSOR USE ONLY ASSESSED VALUE I HOMESTEAD VALUE NON- ESIDENTIAL
VAL
Land not exceeding one(1)acre immediately
surrounding residential improvements (1)
t
Other land (2)
Total land(line 1 plus line 2) (3)
Residential improvements or Dwelling (4) Y ti„
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)
30,; I;.,�/l 12/27/19
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)
-4,1,4,1_. 1.. 0 12/27/19
DISTRIBUTION:Original-County Auditor,File-Stamped Copy-Taxpayer
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