HomeMy WebLinkAboutHomestead_Mason (8) i
-� „ CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
STANDARD I SUPPLEMENTAL DEDUCTION FORM
Slate Form 5473(R15/1.20) HC10 2020
Proocnhed by the Deportment of Loco'Govemmenl Finance
INSTRUCTIONS'See reverse side for filing intrusions
NOTE Telephone,Social Security,driver's license,state dunlificahun and federal identification numbers aro confidential under IC 6-1 1-12-37
v sn " ..,. 'i' ;.'° _-, GERjTF,ICATIO ;SSTATEt fNT 2 R _, F., ' a•~:°1 :..a
I(We)_ Hillari Mason 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
OodUctioa Is hereby claimed on the dale this application is signed. I- e�- o��c�\ (date of signature). I(We):
0 Own, D Am(are)buying under recorded contract.
El 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.
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•,i.., ,�, a ._+"•:,�'v. ,r'c �•�CONT...._D,T RQCJ�PfrD�..:;..�.=:#�� a .<�a..-....,s�em:�•_�",:,• "�-rrs.=
If buying on contract Foe Simple awet's norms
fierm0ers uRco!Win contract is recorded -_...,.....-_-- -�-- - Record number rcge
,
P,RDPERVAPESCRIgTIONF. +i ,.a=4 3is 1M4 ` t�>-_
County Township Taxing district(city town,township) /j
Gibson Patoka Township Patoka Township A..1
Pnrcol nuvhnr - Legal description )Is lira property in question /
26-12-29-100-001.768-027 W NW 29 2 10 1.4459 AC Gd Real property ❑Annei motile Name(IC 6.1,f•T)
1f any pardon of the resklennal structure or the land not exceeding ono(1)acre Mot Immodialely surrounds that etructure m used to produce income, h u,ArrEh p fr
of tin property Wheedle produce Income u�T Y 7
quo'To0
(?6f;ROP,fR OWNS-ELSEWHER B, GTAIMAN.TAt: �.c:rx"�"7` 7' l
State.County,and Townah p
to dalmnnl vacating a homestead?
t - Yos (Zl No
Signs ere Tlel m.
I hereby certify the above statements are true,correct.and completes
uJ�dot
Adam.of coolest biwntiar and shoot,Fey,stela,and Dp code) A almse of vacated liomesland,it any(numborand s!m+ city,stale,and7.lP code)
623 E 250 S,Princeton, IN 47670
l � tat'sAs„`s- ll ASSESSED VALUE7•'. .I 4irOM STEAD
Land not exceeding ono(1)acre Immediately (1}
surrounding residential Improvements
Other land (2)
Total land(fine 1 plus fine 2) (3)
Residential improvements or --- Dwelling (4) -_�-•W�
annually neSe00041 meblio I — - — —
manufactured horse Garage (5)
Ogler Improvements (6)
Total Improvements(llna 4 through tine 6) (7)
Total value (line 3 pis Roe 7) (g)•
I hereby certify the above IS true,correct. Signature of Assessor Data signed(month,day,year)
and complete. '
venlymg ud:en,Sigoamra of Andilor Dale signed(month,day.year)
S ANDA tli`DSUCT Z C
20 pay 20,- _ Lesser of tiO%of the assessed vdue of tire homestead or 515,000,
I I i' iNRhvillsiartdlnq any otherprevsion,The sum of the deductions provided in IC 6-1.1-f2 to a mobile home $
t7if is not assessed as real property or to a manufactured home that is not assessed as real properly may
not axcedd ora-hha/f(1,2)of the assessed value of the mobile home or manufactured home, I _
S poke()of NrU.lor _ Dote signed(month,day,yaw)
tf
oIOTRIeV ON:Ong.nal-County Auditor,Fee-Stamped Copy•Texpoyer
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