HomeMy WebLinkAboutHomestead_Johnson (7) f CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
:•.4;„�a (STANDARD/SUPPLEMENTAL DEDUCTION FORM
`r HOW �'D
' tate Form 5473(R17/1-16)
'rescnbed 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.
�,i,� CERTIFICATION STATEMENT
• I(We) ' `r lY l O■L 1 V 0 . 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):
j Own. ❑ Am(are)burying under recorded contract.
��AAm(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.
(Applicable only if appiicant's spouse does not have a social security number.)
CONTRACT RECORDED
If buying on contract,Fee Simple owners name
Recorder's office where contract is recorded Record number Page
PROPERTY DESCRIPTION
County Township Taxing district(city,town,township)
Parcel number Legal description Is e p petty in question:
Real property ❑Annualiyassessed 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 structure is used to produce income,describe the use and portion
of the property utilized to produce income.
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State,County,and Township Is claimant vacating a homestead?
❑ Yes ❑ No
Signal
i hereby certify the above statements are true,correct,and complete.
•
Address of contact(numberandadae4dty,state,and ZIP code) ddofvacm h #if any(number and street c14ç vista,end ZIP code)
20 4 t t c.,k) & t le -3 n
ASSESSOR USE ONLY ASSESSED VALUE ' HOMESTEAD VALUE I NON-RESIDENTIAL
VALUE
Land not exceeding one(1)acre Immediately
surrounding residential improvements (1)
Otherlantl IL � y`.,.a'`
Total land(line.:plus line 2) F •
Residential improvements or Dwelling (4) x
annually assessed mobile I
manufactured home Garage (5) FEB 2 6 2020 f <v ti
Other improvements (6)
r
Total improvements(line 4 through line 6) (7) l f>otg-* M ,
Total value(line 3 pits line 7) (j��F1N COUNTY AUDITOR
I hereby certify the above is true,correct, �oign of Assessor Date signed(month day,year)
and complete.
Verifying action-Signature of Auditor Data 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 properly or to a manufactured home that is not assessed as real property may
not exceed one-half(1/2)of fhe assessed value of the mobile home ormanufachued home.
Signature of Auditor `.."--- _` (. : ;öT\).` Dateay 02D•
DISTRIBUTION:Original-Caurt dd yAuor,File-Stamped Copy-Taxpayer 2
Page 1 of 2