Homestead_Mosley 1,2/27/21 15:58:10 Ascension -> 8123861173 Ascension Page 882
CLAIM FOR HOMESTEAD PROPERTY TAX ( FORM YFAR
r' STANDARD f SUPPLEIMENTAL DEDUCTION 4 ticto 1 2[)21
sue sera 6473 Otter SW).a. i, Proaar.e MOM O.pwa..ra at Leon Oooininow Fie..
INSTRUCTIONS:See memo seta far MOM►rsMectkm.
NOTE 1htpfamr.soda Seaway,drire711 Weems MM. dr'ma hoard khetdwdan numbers w.co,,l , at order IC 61.1-12-3r.
I(We) James S.Robyn Mosley certify that I(we)occupied ea my(out)principal
place of reSMwroe or era(are)buying(tee following described red Duo"oeIr�Oc)urdex ar
for which a Homestead Property Tax Standard
Deduction Is hereby claimed on the date this applicationi I.signed, 'P- m Q2i.l (dote-cif aiptaawe). 1(we):
RI Own. 0 Am(ere)buying under recorded contract.
0 Am(are)wattled to occupy as a ten.nl-atodkhblder of a cooperative housing corporation.
❑ Have a benaeeflei intered in the Wet or the right to occupy one property under the termw.of a qualified personal residence trust..
(] An,(are)the shsraholder,partner,or member of the entity that owns the property,
If bone m rsneact roma it
,IVneaen's innne,Mere mba.*.moewd Record mama.. Pos. 471D
County 'Beneerle. Tears dsY.tl(d7•Ieer4 IO.rrr$i*)
DFC27
Gibson Frartdaoa Francisco C'i@s -+ .�,. �6�/
Pees meows tapir eieeheen lathe teepee"in question' C
(�Ron,P.Cnny C3 lu.rowlv.+r.e.d mobile t...n.I 64.t.rti'.0 -c-
if of tie-000.w awe. CURLESS ADD 1 J
e..yami+a.a.r»,..{a.moons•,r.>v..,..amen.r.o.ea••seer(1)•,x+s.werrr...arr.anw,naa Sot.wow•r.ease,oPr.dYAx.exem.d►ua.o.m.too and varur.m UNTy�Ua
d a..p•oety o.acae to pease Intents /Tp
R
SI*,Counts sot Towel* la claimant vacartng a homestead?
0 Yes I3 No
I hereby certify the above statements are true.correct end complete. J✓e^s+� //)-)
Adeess al contact f,00rwar ens Mom dy,web,was 21Praeh) r ar mucus .hed m
sr s h.. . .if y(n arose.Non slats and Hem..)
403 E Wood SI,Francisco.IN 41849 • _
Ira:::dtsvaerce=172 at)1 zIn.a.adl.taty (t) z..7- f:ro ... .
other land (2) h t . .-
Total lend glee 1 phi.lima 2) (3) t
R.sfdentlet k.yreseerr. i�.
a
annually es.aeaed mobile or ba.N{rq l 1 _ �i f _ -a.a..hean.d hone Stamm 0) 0a ...
Other esprwwsemb sott-
r
Total Impra'wmOnb(wee 4 drreuga le ) (T)
Total value(hw t (Ma 3 plus Ono 7) le)
bl..aara Nlaea.e� o.r.q..ad(mesh.sex Yarn?
I t .bycertify Ut.above as true.carnal.
and aawsdrb. twx wined Vrrorun,coy.son
acre.-Sig ehar of Audi.
20 coy 20 Leaser or eo%or we eaMwsea veua or the horr.sateed or$46.000-
Nonninatartaim en yarn.,py bears,at.sum of she Owduotlarts podded Or IG It.I-12 to a mob%horn. S
Willa not aSMlaed as Me pcp.rty Pero a,t.rsuhcitsealloore that Is,lot saxes...d as rear propaM rosy
not~ma aeta4M,tl(tlb)M the assessed viva a1IS.moths.hoar or numurarltwd fame. ape��4r•a+.fur.per.Y.ar7
eitlinx
r e.*A..O-i.Q a -VDZk-9- .- 1--Q-1 a(C)A.I .
ofaThetnrhe. ruse-Cooly Seem FM.Ha,rpo s capy-Tasoner
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