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HomeMy WebLinkAboutHomestead_Heldt (3) ' ,.•;. CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR: .i:`'.. STANDARD 1 SUPPLEMENTAL DEDUCTION n^ ?�f ,, Stele Form 5473(R18/1-20) HC10 � W •y` •. 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 r - .` .. I(We) Heldt..Jason.L 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, 12/03/2020 (date of signature): I(We): 11 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. • - - SocrstSoeurity numberol claunedl's'spouse'(Issf be"its). Diverclbanse/ldenl'aicatiod/Otheinuntber of elabnanl'o spouse•(laptrve4klils)l Issvinp State (Applicable only if applicant's spouse does not have a social security number.) CONTRACT RECORDED . ' • It buying on contract,FeeSimple owner's name — - ' tlecordnts office where contract is"recorded - - _Receid numbtit "Dee': ;) - PROPERTY DESCRIPTION County - . TeCvaship. Taxing district(city,town,township) ' Gibson 028 028 Parcel number " " - Legal description - - Is the property in question: m Real property 0 Annually assessed mobile home(IC e-t,1-7) 'new pottlpn el lhq fesidentia14tructure er Iho-tiled not exceeding 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. 26-12-07-103-000.952-028 PROPERTY OWNED ELSEWHERE BY CLAIMANT :state.County.and Township Is claimant vacating a homestead? m Yes ❑ No Signature of darmantD I hereby certify the above statements are true,correct,and complete. Address of contact(number and street.city,state.and ZIP code) Address of ed homestead if any(number and street,city,state,and ZIP code) 429 W Emerson, P'ton, IN 47670 244 N CR 700 W Petersburg;IN 47567 - -. . ASSESSOR USE ONLY I ASSESSED VALUE I HOMESTEAD VALUE NONRESIDENTIAL %ml t„ ' 'sbrcoLtidd not exceeding nq eeld nlialImpracre oveoensdtatatg (1) Other land (2) A a Total land(line 1 plus line 2) (3) DEC 1 5 2020 Residential improvements or Dwelling (4) annually assessed mobile I . manufactured home Garage (5) _ .. 1 Other improvements 16) Total improvements.(llne4 through line 6) (7) . GIBSON COUNTY AUDITOR Total value (line 3 plus line 7) (8) y I hereby certify the above Is true,correct, Signature of Assessor Dale s:ned(month,day,year) and complete.: Verifying action-Signature of Auditor Dale signed -•nth,day,year) . STANDARD DEDUCTION ALLOWANCE - , 20 pay 20 Lesser of 60%of the assessed value of the homestead or$45,000. Notwithstanding a other p vision,the sum of the deducli 'ed in IC 6-1.1-12 to a mobile home $ that is not assesse as re' roperty or to a manufact home that is of assessed as real property may not exceed one-ha (1/2) lie assessed value of e mobile home or Anufaclured home. Signature of Auditor -• 'J Dale iglr T. YFr e tsto DISTRIBUTION: ginal- o I ty udilor,File- tamped C -Taxpayer Page 1 of 2