Homestead_Neufelder -te; _ CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
`,;_g� STANDARD/SUPPLEMENTAL DEDUCTION FORM
� ��d, State Form 5473(R17/1-18) Ht:10' 2'�2 0
Prescribes/by the Depar mentaf Loral Government Finance
INSTRUCTIONS:See reverse side for tiling instructions.
NOTE:Telephone,Social Security,driver's license,state identification and federal identification numbers am confidential under IC 6-1.1-12-37.
CERTIFICATION STATEMENT
• I(We)_ V) '-. .II certify that I(we)occupied as my(our)principal
place of residenoe.k am(ar-° • ing the fo • i ng described real property under contract for which a Homestead Property Tax Standard
D ction is hereby claimed on the date this application is signed, (date of signature). I(We):
Own. IDAm(are)buying under recorded contract.
❑ m(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation.
0 ave 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.
CO ITR!CT RECORDED
If buying on contract,Fee Simple owners n- ' _ —
Recorr s office where contract is recorded F EB 2 6 2020 Record number Page
PROPERTY DESCRIPTION
County Townsh:1111filfiffiriff j. Taring district(city,town,township)
(,IRSON COUNTY AUDITOR
Parcel number Legal description Is the property in question:
0 Real property 0 Annually assessed mobile tome(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.
2c— ( ( - I.q - 1-too- 0as 557702, )
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State,County,and Township
Is cl ' ant vacating a homestead?
Yes [(No
I hereby certify the above statements are true,correct,and complete. `
Address of contact(numberand street city,state,and ZIP code) vacated ,ifany number and ,state,and ZIP-• e)
A4 Address' :. _%` ,Z-54 S o - - _ ---3
ASSESSOR USE ONLY i ASSESSED VALUE HOMESTEAD VALUE NON-F ASIDENTIAL
LUE
Land not exceeding one(1)acre Immediately '
surrounding residential improvements (1) w } ,s
:x
Other land (2)
Total land(tine 1 plus line 2) (3)
Residential improvements or Dwelling (4)
annually assessed mobile/
manufactured home Garage
Other improvements (6) ,,• . -,.-..A
Total improvements(line 4 through line 6) (7)
Total value(line 3 piss 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)
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-haff(1/2)of the assessed value of the mobile ho actured home.
Signature of Auditor Date signed( oid,day,
DISTRIBUTION:Original-County Auditor,File-Stamped Copy-Taxpayer
Page 1 of 2