Homestead_Scott (13) 4vrmne, CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
��Nye STANDARD/SUPPLEMENTAL DEDUCTION FORM
' ' [t'2 State Form 5473(R18 I 1-20) ,,,,////����
12-37.
�1(� CERTIFICATION STATEMENT
I(We), �'11 Cl' ' 1 SG� 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):
Own. 0 Am(are)buying under recorded contract.
m(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.
0 Am (are)the shareholder, partner, or member of the entity that owns the property.
(Applicable only if applicant's spouse does not have a social security number.)
CONTRACT RECORDED
If buying on contract,Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
PROPERTY DESCRIPTION
County Township 0 2:9— Taxing district(city,town,township)
Parcel num 30
�` Legal description Is perty in question:
Real property ❑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 surroun 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 v.,,:ng a homestead?
❑ Yes ►S No
//////tttt�� /
Signature of de' ant /' I '
I hereby certify the above statements are true,correct,and complete. Nf V % 1111
I 4�
Address of contact(number and street,city,state,and ZIP code) Address of vacated stead,if any(num•er and st et,c at,and ZIP code)
260q — —WG
ASSESSOR USE ONLY I ASSESSED VALUE I HOMESTEAD VALUE NON- ESIDENTIAL
VAL
Land not exceeding one(1)acre immediately
surrounding residential improvements (1)
Other land (2)
Total land(line 1 plus line 2) (3)
ILEUTT
Residential improvements or Dwelling (4)
annually assessed mobile/ s
manufactured home Garage (5)
Other improvements (6) S •
Total improvements(line 4 through line 6) (7) 2U L0 C
Total value (line 3 plus line 7) (8)
I hereby certify the above is true,correct Signature of Assessor onth,day,year)
and complete. ++''���{TT��rr pp t(''�
Verifying action-Signature of Auditor G :SUN COBbfe`stgnxd•(rhYnfFdXOR
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 pro or a manufactured home th of a d as real property may
not exceed one-half(1/2)of the ss ed value of the mobile h e or manufactu d home.
Signature of Auditor ‘Copy
Date signed imrth,da 7)0
DISTRIBUTION:Original-County Audit le-Stamped Coopally-Taxp er /�-'(�`
e of 2