Homestead_Greer -0-*--, CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
i.. STANDARD,/SUPPLEMENTAL DEDUCTION
FORM
CState Form 54734.0 j
/1-20)
*---,,,,, :‘..'• Prescred by t Departent of Local Government Finance
HC1O
1 '-'71.-.0'2,L.
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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) , al certify that I(we)occupied as my(our)principal
place of residence or am are buying the following described real',per u delEntract for which a Homestead Property Tax Standard
Deduction is hereby claime n the date this application is signed, aS , I ___4., (date of signature). I(We):
Own. CI Am(are)buying under recorded co tract.
Am (are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation.
ri Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified personal residence trust.
El Am (are) the shareholder, partner, or member of the entity that owns the property.
CLAIMANT'S INFORMATION
CONTRACT RECORDED
If buying on contract,Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
PROPERTY DESCRIPTION
County Township 0 2,2) Taxing district(city town,township)
Parcel number Legal description
Is the operty in question
Real property L] Annually assessed mobile home VG 6-1 1-7)
If any portion of the residential structure or the land not exceeding one(1)acre that immediately surro nds hat structure is used to produce income.describe the use and portion
of the property utilized to produce income
- 0 (Do. 003 . 0
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State,County.and Township In claimant vairt a homestead?
_L.i Ye No
r IA hereby certify the above statements are true.correct,and complete. „...>'''1.7'.
Address of contact number and street.citstatl d and ZIP code) r..•res of vacated homestead i any(number and street,city.state,and ZIP code)
II .. , .
- ._,'r\- 1-<3
ASSESSOR USE ONLY ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL
VALUE
Land not exceeding one(1)acre immediately „ -/irw, rr .:: , ..i..-'. , -- -
_surroundin_a_residential impn_avements
Other land (12) ------ -71 '')Ii Orict 11kiql..-4
Total land(line 1 plus line 2) (3)
Residential improvements or Dwelling (4) ::r;lii: „,".Fr "i'L,i ,,i'y',:-
annually assessed mobile) MAR04-2M
manufactured home Garage (5)
Other improvements (6) . .twirt:eT.,t'r
_ • 22,,,,,,,,,i-eZ-.tiv.,,:i ) '
Total improvements(line 4 through line 6) (7) _CTBSON-00-14NT-Y-Att-DtTOR
Total value (line 3 plus line 7) (8)
Signature of ASSeSSOF 1 Date signed(month day.year)
I hereby certify the above is true,correct,
and complete.
Verifying action-Signature of Auditor Date signed(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 6-1.1-12 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 „gra:- e or manufactured home.
—6Tanature of Auditor Desri (mon daY.Y..)(—LA_
'CVAW .
DISTRIBUTION: Original-County Auditor,File-Stamped Copy- S.
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