Homestead_Buchanan r -, ejR�4 CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
it._ -ni-; STANDARD/SUPPLEMENTAL DEDUCTION FORM
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, State Form 5473(R18/1-20) HC10 2020
"i � 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) Buchanan, Robert Lee 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):
I 1 Own. ❑ 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.
CLAIMANTS INFORMATION
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•-'.-,_.,cONIRAf'T RFf Rf1Ffl,y _. -_.._.>Q.� __
If buying on contract,Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
PROPERTY DESCRIPTION
County Township Taxing district(city,town,township)
Gson gibson 006
Parcel number Legal description Is the property 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 surrounds that structure is used to produce income,describe the use and portion
of the property utilized to produce income.
• 26-13-36-100-000.697-006
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State,County,and Township Is claimant vacating a homestead?
Yes ❑ No
-- t
Signatu of claimant*
I hereby certify the above statements are true,correct,and complete. cc./ Yt�L�!�I _ _ _ i.
Address of contact(number and street,city,state,and ZIP code) Address of vacated homestead,if any(numberand street,c`ity,sstate,and ZIP code)
3796 S SR 57, Oakland City, IN 47660 3800 Katalia Dr, Newburgh, IN 47630
ASSESSOR USE ONLY I ASSESSED VALUE I HOMESTEAD VALUE 'NON-ESIDENTIAL
VAL
Land not exceeding one(1)acre immediately (1) t� a
surrounding residential improvements - --
Other land (2) / 7
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Total land(line 1 plus line 2) (3) ,
its - o •
Residential improvements or Dwelling (4) 1.7 `.`
annually assessed mobile/ v
manufactured home Garage (5) ‘W—C, ,:
Other improvements (6) -
Total improvements(line 4 through line 6) (7) (.CQ\�Q
Total value (line 3 plus line 7) (8) Qr GQUN��
I hereby certify the above is true,correct Signature of Assessor Date signed(month,day,year)
and complete.
Verifying action-Signature of Auditor Date 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.ther.I.•• 'on,the sum of the deductions provided in IC 6-1.1-12 to a mobile home $
that is not assessed.'s real .erty or to a manufact at is not assessed as real property may
not exceed one-half /2) ' e assessed value e mobile home r manufactured home.
Signature of Auditor , cM J D1te sig d-11h, a '
t DISTRIBUTION: Original-C•1-tyAuditor,File-Stamped Copy axpayer 7/
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