HomeMy WebLinkAboutHomestead_Chandler CLAIM FOR HOMESTEAD PROPERTY TAX FORM 1 YEAR -
STANDARD State Form 5473(R1/6SUPPLEMENTAL DEDUCTION HC10 I !�p�`
� Prescribed by the Department of fatal Government 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) ) A. •.�_A '.• L OL' Vt\\(t' certify_„__ that I(we)occupied as my(our)principal
place of residence or am(are)buying the folio ing described real prope y f de r„gntra t for which a Homestead Property Tax Standard
Ded tion is hereby claimed on the date this application is signed, _ -L .._�__ .(date of signature). I(We):
Own. (.J Am(are)buying under recorded c ntrac. Jr�,Jr�'"
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. Q
LI Am (are)the shareholder, partner, or member of the entity that owns the property. &c C,s\srIL
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Recorder's office where contract is recorded e d numberSage t.
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PROPERTY DESCRIPTION
County Township Q 2 V. Taxing district(city,town,township)
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l-illarcel nuinbe Legal descriptioni _ .. th roperty in question ........
Real property 0 Annually assessed mobile t (IC 6 1 1 7)
If any portion of the residential structure or the land not exceeding one(1)acre that immediately surrou ds th t structure is used to produce income,describe the use and portion
of the property utilized to produce income
( .- 1 — o ( .— yOy —COO - CA6-7-- \Dz.'
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State,County,and Township Is claimant scati..a homestead?
[] Yes ktl No
Signatu ant ,�
I certify the above statements are true,correct,and complete.V �,•�et
e t�f�` tree_ ._.a..
Address o contact u ber and feet,city,state,and ZIP code) D 1 A•' vacated homestead.if any(number and Street,city state.and ZIP code)
5 S tiN • e_.. S r_ . ,In •
ASSESSOR USE ONLY ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL
VALUE
Land not exceeding one(1)acre immediately surrounding residential improvements (t) ~'nTv_ ')' '� •�
Other land (2) = F ^a x *-'
Total land(line 1 plus line 2) (3)
If
Residential improvements or Dwelling (4) v 1r ''.Iby3s ` f
3
annually assessed mobile/ ------ -- - --_------ trnyp„yryat' ` "
manufactured home Garage (5) _ , , ....c--
0 ;si .�g. >r5 c of
Other improvements (6) _........_ -__ .n `
Total improvements(line 4 through line 6) (7)
Total value (line 3 plus line 7) (8)
1 I hereby certify the above is true,correct, Signature of Assessor Date signed(month day year)
and complete. ----,- __
Verifying action-Signature of Auditor Date signed(month,day.year)
I
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/C 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 obile home or manufactured home.
Signature of Auditor_ _ - 3 A./ : Date si q(-(1m h,d. ay,year)
DISTRIBUTION: Original-County Auditor,File Glen-teed Copy-Taxpayer l
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