HomeMy WebLinkAboutHomestead_Brown (29) r ter, CLAIM FOR HOMESTEAD PROPERTY TAX -YEAR
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„ ;;,8 STANDARD/SUPPLEMENTAL DEDUCTION FOIE
1► ' �:' State Form 5473(R17/1-16) HCIO 2-131q
Prescribed by the Department of Local Government Finance •
INSTRUCTIONS:See reverse side for Mg instructions.
NOTE Telephone,Social Security,driver's license,state identification and federal idenfificafon numbers are confidential under C 6-1.1-12-37.
CERTIFICATION STATEMENT
I(We) !A . '10 VA) 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, (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.
)
CONTRACTRECUPDFD
if buying on contract Fee Simple owners name - -
Recorder's office where contract is recorded Record number Page
JAN ► , a,
PROPERTY DESCRIPTION
County \ Township Taxing district(city,town,township)
_ r
[ i Ii,.
Parcel numbe Legal description G I B S O N �'-'rr on: ..
I_:1 Real property—D I�, ilyassessed mobile home(IC 6-1.1-7)
If any portion of the residential structure or the land not exceeding one(1)ace that immediately surrounds that structure is used to produce income,describe the use and portion
of the properly utilized to produce income.
u!,,\6 ,21..i, 2-- 3- Q2C .
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State,County,and Township Is dal ant vacating a homestead?Yes ❑ No 5p.. 4(1
e Situp`_-a,mard r . �j
I hereby certify the above statements are true,correct,and complete.
Address of contact(numberand a6wk city,state,and ZIP erode) • Add--of vacated homestead,if any(number and street,city,state,and ZIP code)
b6 •- • Lj - �1 Or\
ASSESSOR USE ONLY I ASSESSED VALUE i HOMESTEAD VALUE NON-RE IIDVALUENTIAL %
Land not exceeding one(1)acre immediately (1) '
surrounding residential improvements - 'S .r_ti ,_
Other land (2) '
Total land(line 1 plus line 2) (3)
Residential improvements or Dwelling (4)
annually assessed mobile 1
manufactured home Garage (5) :&' } ..,_._
Other improvements (8) •
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 Aucgtor Date signed(month,day,year)
STANDARD DEDUCTION ALLOWANCE
20 pay 20 Lesser of 60%of the assessed value of the homestead or$45,000.
Nofwithstandi •a o•- 'revision,the sum of the deductions provided in IC 6-1.1-12 to a mobile home $
that is not a-'-sse•'=. -al properly orto a manufactured home that is not assessed as real property may
not exceed on half r)of the assessed value of the mobil me or manufactured home.
Signature ofAudito Date signed(month,day,year)
DISTRIBUTION:Original-CountyAuddor,File-Stamped Copy-Taxpayer
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