Homestead_Siekman (9) c,, CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
�,�" STANDARD/SUPPLEMENTAL DEDUCTION lam FORM
Oi �I' State Form 5473(RIB
Dep/1-20) a.„(
( HC1O 2020
�,—,'/ 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) Danny Ray Siekman 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):
I1 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.
CLAIMANT'S INFORMATION
Name of claimant(legal name) Telephone number of claimant
Danny Ray Siekman ( )
Social Security number of claimant(last live digits) Driver's license/Identification 1 Other number of claimant(last five digits) Issuing State
(Applicable only if applicant does not have a social security number.)
Name of claimants spouse(legal name)
Social Security number of claimant's spouse(last five digits) Drivers license/Identification/Other number of claimant's s e(last e d ts) 'ng State
(Applicable only if applicant's spouse does not have a social security ber
CONTRACT RECORDED
If buying on contract,Fee Simple owner's name '
Recorder's office where contract is recorded Record numbe0�0 Page
0/eS
PROPERTY DESCRIPTION
County Township Taxing district(city,town,township) ' ei(J0/-`97¢1
Gibson Barton Gibson, Barton
TOR
Parcel number Legal description Is the property in question:
26-20-27-100-000.944-001 II Real property 0 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. _
ORIGINAL HOMESTEAD HS E EN_MISP .CED THISIS.A-REPLACEMENT_HOMESTEAD?•- DCr oCame •i nCD,rr\p�k-t_cl � S C a - I lj lot a , a (Lsc>i \u_`�
e \,JcP A5ab1e. o ��l -,Sc Ne_ C�CLme \a-as-aoap d-
•
PROPERTY OWNED ELSEWHERE BY CLAIMANT -- /� v�,(�te,�,,p
State,County,and Township Is claimant vacating a homestead? `(��,1^' -1J t l..\
Indiana, Gibson, Barton 1 ' ❑' Yes gj•No tiSGLIP'Ili'k
I hereby certify the above statements are true,correct,and complete.
oey"..4../ii‘efr...1„?.......„
Address of contact(number and street,city,state,and ZIP code)
8612 S 820 E, Elberfeld, IN 47613 Si ature f authorized r resen alive
ASSESSOR USE ONLY ASSESSED VALUE" ,I HOMESTEAD VALUE "Th:NON.RESIDEN AL
VALUE The_ 1 j
Land not exceeding one(1)acre immediately Y JI7�
surrounding residential improvements (1)
Other land (2) 'h N.7 leer'
Total land(line 1 plus line 2) (3) iv-\\50
Residential improvements or Dwelling (4)
annually assessed mobile/ ,,
manufactured home Garage (5)
Other improvements (6)
L
Total improvements(line 4 through line 6) (7)
Total value (line 3 plus line 7) (8) '�v
,(�I IS
I hereby certify the above is true,correct, Signature of Assessor Date signed(month,day,year)
and complete. 4C—fin L- 1 1,
Verifying action-Signature of Auditor Date signed(month,day,year) `I"hf(
STANDARD DEDUCTION ALLOWANCE c/�V,`-�, iC\d .
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 property or to a manufactured home that is not assessed as real property may
not exceed one-half(1/2)of the assessed value of the mobile home or m nufactured home.
Signalu a of Auditor , Date signed nth,day,year)�1 ^^ V
irr\?3_,1/4.....)
DISTRIBUTION:Original-County Auditor,File-Stamped Copy-Taxpayer
1 ■ , l
Page 1 of 2