HomeMy WebLinkAboutHomestead_Cundiff CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
STANDARD/SUPPLEMENTAL DEDUCTION FORM
' ,,,L State Form 5473(R18/1-20) HC70 ��� /■(/
Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for filing instnlctions.
NOTE:Telephone,Social Security,driver's license,state identification and federal identification numbers are confidential under IC 6-1.1-12-37. 0
CERTIFICATION STATEMENT
I(We) rl^`• A.. ( ,4 C'1 ea. \�f•-c certify that I(we)occupied as my(our)principal
place of residence or am(ar ng the following described real property under contract for which a Homestead Property Tax Standard
Deductiondu' is hereby claimed on the date this application is signed, (date of signature). I(We):
ly4'Vwn. ❑ 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.
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(Applicable only if applicant's spouse does not ilf y b
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\\\„/ If• ying on contract,Fee Simple owners name CONTRACT RECORDED J N
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ecorder's office where contract is recorded 110FRe number
2154414)
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PROPER rY DESCRIPTION V
Gounry� ''Township Taxing••' ct(city,town,township Q' v
Parcel number Legal description Is the property in question' j (I) ___L-Z
_____/"..6
S l� onec f .Re$1 roperty ❑ Annually assessed mobile home(/C 6-1.1-7)
i If any portion of the residential structure or the land not exceeding (1)acre that immediately surrounds that structure is used to produce income,describe the use and portion
of the property utilized to produce income.
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,- 1 -a--a0, -- . 00 - 00 ( .°, \S - ID'D 7 �-
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State,County,and Township Is claimant vacating= omestead?
❑ Yes II o
SigpwNi(e of claimagt ' '- -) Nil
I hereby certify the above statements are true,correct,and complete. St,/� _ ai�
Address of contact(number and street,city,state,and ZIP de) Address of vacated homes'' ny(number and srrer\ state,and ZIP code)
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ASSESSOR USE ONLY ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL
VALUE
Land not exceeding one m acre Immediately 5 i1 '%'E� n i
surrounding residential improvements (1) .,•.,x..,=.w, �/�. �,�.
Other land (2) AtHelitftelegt
Total land(line 1 plus line 2) (3) E
_ .}
Residential improvements or Dwelling (4) c:'-''"�• " �,'" r. 4—
annually assessed mobile/ a
manufactured home Garage (5) r �a �
Other improvements (6) IOO', '� ` /�
Total improvements(line 4 through line 6) (7) "�J
Total value (line 3 plus line 7) (6) g
I hereby certify the above is true,correct, Signature of Ausessor Date signed(month,day,year) S
and complete. �„
Verifying action-Signature of Auditor Date signed(month,day,year)
.„-. 1
STANDARD DEDUCTION ALLOWANCE
20 pay 20 Lesser of 60%of the assessed value of the homestead or$45,000. IS
Notwithstanding any other provision,the sum of the deductions provided in IC 6-1.1-12 to a mobile home $ „j,.. ✓
that is not assessed as real properly 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.
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Signature q[-Audilor Date signed(month,day,year)
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DISTRIBU N: Original-County Auditor,File-Stamped Copy-Taxpayer
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