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Homestead_Meny (4) CLAIM FOR HOMESTEAD PROPERTY TAX ,IF : ? STANDARD/SUPPLEMENTAL DEDUCTION I FORM I I YE AR State Form 5473(Rig/1-20) '1 I Prescribed by the Department of Local Government Finance HC10 OCI 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)3phaMICl17Pl/r(/Prty/Lj SC, /4tA our)principal place of residence or am(are)buying the following des�ed real prop under contract for which a certify that I(Homewe) stead Property upied as my(Tax Standard Deduction is hereby claimed on the date this application is signed, 5'eL 7 -2).-- (date of signatta g I(We): /wn. ❑ Am(are)buying under recorded contract. 0 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. 0 Am (are)the shareholder, partner, or member of the entity that owns the property. �\\ V. — -..—Si a Recorders office where contract is recorded r Record number Page county PROPERTY DESCRIPTION Township Taxing district(city,fawn,township) ` (� /�SO✓1 /^ /�/1� . $ Parcel number Legal description l Is l a o 'v t o -(— (/�/�� ^L/ Is the property in question: {• t262_��_(P OC)—M(• Y LReal property ❑Annually assessed mobile home(/C 6-1.1-7) - r-y If any portion of the residential structures or theland not exceeding one(1)acre that immediately surrounds that structure is used to produce income,describe the use and portion N.1 VOWS of the property utilised to produce income. (. )� :1- a _g_u_ t_ :-- PROPERTY OWNED ELSEWHERE BY CLAIMANT N f`",s,, State,County.and Township V.Is.:i•.cat vacating a homestead? T .5', I41 Yes Q-IcIo t_ I hereby certify the above statements are true,correct,and complete. .j, ` Im.nte• I _ / 00 Address of contact(number and street,city,state,and ZIP code) .d of vacated home- • (l eatl,if anmbar street,city state,and ZIP code) G 0__.- (0�090 .e a !e. Oct IA,-'J C C. -i J 17640 . 8• O lc�d_ —Jh—9 o— r, ASSESSOR USE ONLY I I I l [� n ASSESSED VALUE HOMESTEAD VALUE VALUE NON-RESIDENTIAL Q (^—3 Land not exceeding one(1)acre iemsdiately Q VI surrounding residential improvements (1) en / r Other land 3 (2) -C Total land(line 1 plus line 2) (3) �—� Residential improvements or O"'61 1' annually assessed mobile/ Dwelling (4) 1 3 manufactured home Garage (5) (� Other improvements (6) tS { Total improvements(line 4 through line 6) (7) S� S Total value (line 3 pits line 7) (6) US I hereby certify the above is true,correct, Signature of Assessor Date signed(month,day,year) _a G and complete. j�}�- Veriying action-Signature of Auditor Date signed gna (month,day,year) STANDARD DEDUCTION ALLOWANCE .C.:), F_ 20 pay 20 Lesser of 60%of the assessed value of the homestead or 545,000. Notwithstanding other provision,the sum of the eductions provided in IC 6-1.1-12 to a mobile home $ that 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 Auditor E IDate signed(month,day,year) DISTRIBUTION:Original-County Auditor,File-Stamped Copy-Taxpayer Page 1 of 2 w � - . H. PREPARER Preparer of the Sales Disclosure Form Title Lindsay M. Phelps Searcher Company Address(number and street,city,state,country,and ZIP Code) 226 W Broadway St, Princeton, IN, USA, 47670 I. SELLER(S)/GRANTOR(S) Seller 1—Name as it appears on conveyance document Seller 2—Name as appears on conveyance document Julie A. Terwiske Erica Rummel Address(number and street) Address(number and street) 32 N 950 E 1006 N Jackson City,state,and ZIP Code City,state,and ZIP Code Oakland City, IN 47660 Huntingburg, IN 47542 Country Country USA USA E-mail address best of my knowledge and belief,is true,correct and complete as required by law,and is prepared in accordance with IC 6-1.1-5.5.A person who knowingly and intentionally falsifies the value of transferred real property,or omits or falsifies any information required to be provided,commits a Level 5 felony. Signature of Seller /j �_„ Cature` /o�fS_eller\\/)./(:';-'.P. -ems - /..P.e".,Y 17_.- /lam-�"" `j`—r�P' ed ameofSeller Date signed(mm/dd/yyyy) ed Name of Seller Date signed(mm/dd/yyyy) Julie A. Terwiske /— — Erica Rummel I/6/. . J. BUYER(S)/GRANTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTIONS—IDENTIFY ALL THAT APPLY Buyer 1—Name as it appears on conveyance document Buyer 2—Name as it appears on conveyance document Lisa Meny John Michael Meny Address(number and street) Address(number and street) • 9566E Base Road 680 S SR 57 '\�✓' -(`- City,state,and ZIP Code City,state,and ZIP Code r v kP Oakland City, IN 47660 Oakland City, IN 47660 �� Country Country , \. C-j- USA USA l • f' ductio .Identify all of those that apgly: YES NO eNDITION ..) • CONDI ON 1.Will this property be the buyer's primary 'L� ;�. = 3. mestead r C/C—_,../ residence? Ot 0 .Solar Energy Heating or Cooling Sy 2. Does the buyer have a homestea I;'vacated a u 5.Wind Power Device ® for this residence?If yes,provide a ,rags �¢'a 0 QI 6.Hydroelectric Power Device Address(number and street) �.V +4 0 (ZI 7.Geothermal Energy Heating or Cool bvice nt City,state,and ZIP Code _ fC my Under penalties of perjury,I hereby certify that this S I s Di osure,to the best of my knowledge and belief,is true,correct a complete as required by law,and Is prepared in accordance with I 6-1.1-5.5.A person who knowingly and intentionally falsifies the value of transferred real property,or omits or falsifies any information required to be provided,commits a Level 5 felony.(Note:Both spouse's information,SSN/Driver's License/ID/Other Number is necessary if a Home Lead Deduction is being filed.) Signatur a byer 1 Sig tuft of Buyer 2/ ouse 1--(4 Printed Leg Name of Buyer 1 - Sign Date(MM/ D/YY) Pr d Legal Name of Buyer 2/Spouse zr Sign Date(MM/DD/YY) Lisa Meny Jo Michael Meny La 's License/ID/Other Number I_«a ninits of Buyer 2/Spouse SSN/Driver's License/ID/Other Number t=- - i I - t ©- 7A Zy�Z. (� (A,9 Pag�e 3 �` t' 1 ph0„1 GAJ1t .)1 14'1 el .s V W a.�,� 1 - l 5 U �(� j W L '&,x-N 0 t l�vrn e s}zaa ' '1 E'.,r1 b- (d G ✓►1 v v(,2 \`rt . ^ I,--10- 'I.J j1L31'