Homestead_Schroeder (2) CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
tr of STANDARD/SUPPLEMENTAL DEDUCTION FORM
Stele Form 5473(RIalt-20) HC10
a-J
Proscribed by the Department of Local Government Finance
INSTRUCTIONS See reverse side for hbnptnshucdons
NOTE Telephone,Soaal Secunly,dnver s license,stale Identification and federal Identification numbers are confidential under IC 6-1 1-12-37
"' '+ " ,;g ,CFRTIFICATION STATrLAIENTi _ "`r' -` °
I(We) Calan&Shelby Schroeder certify that I(we)occupied as my(our)principal
place of residence or am(are)buying the following described real property andei contra for which a Homestead Property Tax Standard
Deduction is hereby claimed on the date this application Is signed, /at Z. /ZO Z D... (date of signature). I(We):
® Own. ❑ Am(are)buying under recorded contract.
❑ Am(are)entitled to occupy as a tenant-slockhoider of a cooperative housing corporation.
0 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,
: ' '_
_..,-.�
Recorders ot4-e whore contract is recorded Record number .. ,f•
ops®, :.
`F+F?OPERTYDESCRIPTION ." ."' car )
r� nr
County TownshipTasting district ��r' rti
9 (dry,roan,rewnshrpJ
Gibson Johnson Johnson 32o4'0
Parcel number Legal desrsiptan Is the property in question. G73 -
26-19-35-400-002.710-024 Oakridge Estate Sec C 37 21 Root properly ❑Ann olly3d rape /•r. .•�,:�c6.1.•
If err/portion of are msidenllal structure or the land not excised/up g one(I)acre that Immediately surrounds that atrucfure Is used to produce Income,deee t ,�/S ) l.5 ;0;
of the properly uhized to produce Income rp/- A
Y
q(i0 TOR
y�^'Y'^ [PROPER
.TY OWNED
VNEb ELSEWHERE,BY
CLAIMANT
"° = •N - •'"
Slate,County end Township Is claimant vacating a homestead? r,
❑ Yes c Na
Signalura at do man
1 hereby certify the above statements are true,correct,and complete
Address of contact(number and street arty state,and ZIP rode) Address of vacated homestead,(number and sheet,city state and ZIP node)
4031 E White Oak Ln, Haubstadt,IN 47639 N�
SESSUR USE ONLY, " 7 ASSESSEL)VALU ' •HOLIEST-AD NON R
VALUE, - F:SIDFNTIAL
^w, , ., . .,.c�1� n, =s• ,., °-m. . �°, =VALUt;, . . ,.
Land not exceeding one(1)acre Immediately
surrounding residential Improvements (1)
Other land (2)
Total land(lino 1 plus One 2) (3)
Residential Improvements or Dwelling (4)
annually essoased mobile I
manufactured home Garage (5)
Other Improvements (6)
Total improvements(lino 4 through line 6) (7)
Total value(line 3 pita line 7) (6)
I hereby certify the above Is We,correct, Signature of Assessor Date signed(month day year)
and complete.
verifying action,Stgneture of Auditor Date signed(month,day,year)
',P,,:,,,,,•y-.M.<o- „^m„m s-.,,..- .+.STANDARD"DCDUCTI'ON.r/1LLOl'lANCG - ,
20+pay 20 Lesser of 609E of the assessed vdue of the homestead or 545,000.
Nonwthslanding any other provision,the sum of the deductions provided in IC 6-I.1-12 toe mobile home 5
that is not assessed as real property or fo a manufactured home that is nal assessed as real properly may
not exceed one-half(Ii?)of the assessed value of the mobile home or manufactured home
Signslu o of Auditor Date signed(month,day,year)
aoe
DISTRIRU ON. Original-County Auchlor,Filo tamped Copy,Taxpayer
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