Homestead_Rhodes (2) ..,•,%P.- CLAIM FOR HOMESTEAD PROPERTY TAX
YEAR
STANDARD/SUPPLEMENTAL DEDUCTION FORM t,.
State Form 5473(R18/1-20)
...-•'' d. Prescribed by the Department of Local Govemrnent Finance
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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) . ---.±q....,... D.CS,. .4- ,,,SAN.t.A kc>,.. liZ I.dillk certify that I(we)occupied as my(our)principal
place of residence or am(are)buying the following de ,' ed real property under contract for which a Homestead Property Tax Standard
Deduction is hereby claimed on the date this application is signed, I f: -<Q0.-7-" ......O i (date of signature). I(We):
0 Am(are)buying under recorded contract.
0 Am (are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation.
11 Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified personal residence trust.
0 Am (are)the shareholder, partner, or member of the entity that owns the property.
CONTRACT RECORDED
If buying on contract,Fee Simple ownees name
Recorder's office where contract is recorded Record number au:
I .
PROPERTY DESCRIPTION ...- a
County Township Teeing district(city.town.township) ler
Cc\tc: st--,. . .
-Parcel number Legal dessnption i Is the ptjgerty in question 42/
V.4W.-I Real property LAY/4,61b mobile home(/C 6-//-7) Irr•Nks,.."3
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, ,i ,,.ib alt, '—I portion
of the property utilized to produce income
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PROPERTY OWNED ELSEWHERE BY CLAIMANT
State,County and Township Is claimant vacating a homestead?
Li Yes No
Signature of c ' nt
I hereby certify the above statements are true,correct,and comple)e.
Address of contact(number and street,city,state and ZIP code) A dress of vacated homestead if any(number and street,city,state and ZIP code)
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ASSESSOR USE ONLY ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL
VALUE
Land not exceeding one(1)acre immediately
surrounding residential improvements (1) .,''.,,,,,,i)-.,,,,,,,r,.,;0- .•!i )r*,,-.;,.,,r,4).'r'
Other land (2) ,•,/,'-•4:), '),,,v• e.).p.: w. ,.-)
Total land(line 1 plus line 2) (3)
Residential improvements or Dwelling (4) , 4
,.,.:::'
annually assessed mobile I
manufactured home Garage (5)
Other improvements (6) !.g4.4igiltWOr. -
:M.1'.
Total improvements(line 4 through line 6) (7)
Total value (line 3 plus line 7) (6)
Signature of Assessor Date signed(month day.year)
I hereby certify the above is true,correct,
and complete.
Verifying action-Signature of Auditor Date sighed(month,day.year)
STANDARD DEDUCTION ALLOWANCE
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-/1-12 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 manufactured home.
Signature of Auffitor Date signed(month,day,year)
....
•\-,,,— (33-___1(- - )•• •—,: -.7--2.02-1
DISTRIBV ION: Original-County Auditor,File-Stamped Copy-Taxpayer
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