Mobile Home_Staley (2) CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
STANDARD/SUPPLEMENTAL DEDUCTION `� FORM
HC14
State Forun5473(R77/1-16)
Prescribed by the Depadmentof 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 under1C 6-
CERTIFICATION STATEMENT
t(We) d ' I MIA_ • certify that I(we)occupied-L y . :nncipal
place of residence or am(are)buying the following d- •ed real property under contract for which a Homestead Property Tax Standard
Deduction�^ is hereby claimed on the date this application is signed, S v t0•30.�1 M) (date of signature). VW 2 0 120
E `6 m. ❑ 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 - '•�---j 6 - j
❑
Social Security number of claimant's spouse(last five digits) Driver's license I identification/Other number of claimant's spouse(fast five digits) Issuing State
(Appraable only ifappfwant's spouse does not have a social security number.)
CONTRACT RECORDED
If buying on contract Fee Simple owner's name
Recorders office where contract is recorded Record number Page
PROPERTY DESCRIPTION
County Township Taxing district(city,town,township)
Parcel number Legal description Is the property in question:
❑Real property ❑Annually assessed mobile home(1C 6-1.1-7)
If any portion of the residential structure or the land not exceefng 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.
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State,County,and Township - Is claimant vacating��,'ryo.�a homestead?
I(d
❑ Yes + •
Signature Of claimant Q o
1 hereby certify the above statements are true,correct,and complete.
Address of contact(numberand chum city,state,end ZIP code) Address of vacated homestead,if any glomberand sheet,city,state,and ZIP code)
1 l OS . W• 41 • 2. . , •l4S.
ASSESSOR USE ONLY ' ASSESSED VALUE HOMESTEAD VALUE NON-RESI
DENTIAL
VAL
Land not exceeding one(1)acre Immediately
surrounding residential improvements (1)
Other land (2) _
Total[and(line 1 plus line 2) (3)
Residential improvements or Dwelling (4)
annually assessed mobile I
manufactured home Garage (5)
Other Improvements (6)
Total improvements(line 4 through line 6) (7)
Total value(line 3 plus line 7) (6)
I hereby certify the above is true,correct, Signature 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 otter 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-had(1/2)of the assessed value of the mobile home ormanufactured home.
'hue fAuddwr Date signed(month,day,year)
DISTRIBUTION:Original-County Auditor,File-Stamped Copy-Taxpayer
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