Homestead_Mills iz' CLAIM FOR HOMESTEAD PROPERTY TAX - —' YEAR
. `7 STANDARD/SUPPLEMENTAL DEDUCTION FORM -
L "" ? State Form 5473(R18/1-20) HC10
Prescnbed 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 am confidential under IC 6.1.1-12-37.
CERTIFICATION STATEMENT .
I(We) Jon M.&Shirley A Mills 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, (.4 d (0 '" Q Q (date of signature). I(We):
QJ Own. 0 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.
If buying on contract,Fee Shope owner's name -
Recorder's office where contract a recorded Reco.,..fiber Page
I _ e•
' X
PROPERTY DESCRIPTION
County Townsh'p Taxing district(city town.township)
Gibson Patoka Township -
Parcel number Legal description li Is the property In question'
26-12-17-300-000.587-027 r 2 Real property ❑ Annually used rpop/a p me(IC 6-f.1-7)
If any portion of the residential structure or the land not exceeding one(1)acre that immediately surrounds that sWctueisAsed to income.describe the se and portion
of the property utilized to produce Income C SON
CO
41/
AUa
PROPERTY OWNED ELSEWHERE`BY CLAIMANT '
Slate,County.and Township '""'
{s claimant vocaUng a horriestea, ^.
❑ Yes [ 'No__
Sigriel of claimant t ,
I hereby certify the above statements are true,correct,and complete. " 1^C'1 1 ,� - !�
i
Address of contact(number and street city,stale,and ZIP code) Addiesei o vas eo4 thomestead if any(number,and street,-city,stale,and ZIP code)
520 E 150 S, Princeton, IN 47670
ASSESSORUSE ONLY I ASSESSED VALUE.. I. HOMESTEAD VALUE 'I 'NON-RESIDENTIAL
•
VAL'U.E
Land not exceeding ono(1)acre Immediately
surrounding residential Improvements (I) .
Other land (2) `
Total land(line 1 plus line 2) (3)
Residential improvements or Dwelling (4)
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)
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 S
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.
Sign ure of Aud for Date signed(month,day,year)
DISTRIBUTION: Original-CountyAud.tar,file-Stamped Copy-Ta ayer
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