Homestead_Cole (2) S±.'`74- CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
a(•= _, FORM
: tpt STANDARD /SUPPLEMENTAL DEDUCTION
'' .f `11' State Form 5473(R18/1-20) NCI() 2020
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,eio Prescribed 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.
CERTIFICATION STATEMENT
I (We) Jared W/ Kathryn S Cole 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, i '/2020 (date of signature). I (VVe):
I0 Own. El Am (are) buying under recorded contract.
❑ Am (are) entitled to occupy as a tenant-stockholder of a cooperative housing corporation.
El Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified personal residence trust.
El Am (are) the shareholder, partner, or member of the entity that owns the property.
CONTRACT RECORDED -
If buying on contract,Fee Simple owner's name
N/A
Recorder's office where contract is recorded Record number•
Page
PROPERTY DESCRIPTION
County Township Taxing district(city,town,township)
Gibson Patoka Patoka Township
Parcel number Legal description Is the property in question:
26-11-16-200-004.700-027 Pt E NE 16-2-11 1.00 AC IZ1 Real property El Annually assessed 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 that structure is used to produce income,describe the use and portion
of the property utilized tb produce income.
N/A
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PROPERTY OWNED ELSEWHERE BY CLAIMANT
State,County,and Township Is claimant vacating a homestead?
N/A ❑ Yes 1No
Sig atu of claimant ��-�
I hereby certify the above statements are true, correct, and complete.
Address of contact(number and street,city,state,and ZIP code) Ad re of vacat d homestead,if any(number and street,city,state,and ZIP code)
971 S 350 W, Princeton, IN 47670
ASSESSOR'USE ONLY ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL
VALUE
Land not exceeding one(1)acre immediately (1) ,rt
surrounding residential improvements �'°
Other land (2)
Total land(line 1 plus line 2) (3)
Residential improvements or Dwelling (4) _
annually assessed mobile/ _
manufactured home Garage (5) Fit h°
Other improvements (6) '
Total improvements(line 4 through line 6) (7) • L 'I 4 20pp
Total value (line 3 plus line 7) (8)
hereby certify the above is true,correct, Signature of Assessor d;ISSO tD Date signed(month,day,year)
e by rt fy N COl rnk