Homestead_Thomas CLAIM FOR HOMESTEAD PROPERTY TAX .
YEAR
.._,6%.' -2•7„.'N-' STANDARD/SUPPLEMENTAL DEDUCTION FORM
State Penn 5473(R17/1-18) NCI 0
'- ----;" Prescribed by the Department of Local Government Finance
INSTRUM7ONS:See reverse side for filing instruclions.
NOTE Telephone Social Security;&Nees Scense,state idenfiecabon and federal idenlilicafron numbers are confidential 7 r lO 6-1.1-12-37. '..1
CERTIFICATION STATEMENT
:... .... /....v/. I(We) ,..d019 .41.. ••• 411.41.,e_t_ed certify th- (we).. . ..,- arilli 47 lip
place of residence or•m(are)buying the fouowing• A-•-,bed real property under contract for whi-- a Homestead P ••• -• -•- -, ._._
Deduction is hereby claimed on the date this applica c•a is signed,
Own. CI Am(are)buying under recorded contract MAY 7 2018
D Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporati (dale of signature). I(We):
0 Have a beneficial interest in the trust or the right to occupy the property under the terms • a qualified anal;est.,- •-- •, st
0 Am(are)the shareholder, partner,or member of the entity that owns the property.
County Township Taxing cfistrict(oly,town, p)
tile......6
Parcel number description Is the prop in question:
tAlf.:4e..dte,17 tada r9I7e/V/71 "P'rr E]Anntsally assessed rnobie home(IC 6-1.1-7)
If any porton of the residential structure or the land not exceeding one(1)acre that Immediately surrounds that structure is used to produce income,describe the use and portion
of the property utilized to produce income.
CA 4, --/.5)."" /q - /67/..'- e)o a. "7 ei-0.1,4,
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State,County,andTownship
Is claimant vacating a homestead?
0 Yes 0 No
I hereby certify the above statements are true,correct,and complete. illf e of dal
of contact(numberand stme4 cit Y.sletc.r .... ) Addretas of ,If any(number ant i city,sheet, sterfe,anclZ/Pcode)
te d.''''' '.0 f , ,fri....61
ASSESSOR USE ONLY ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL
VALUE
Land not exceeding one(1)acre Immediately
surrounding residential improvements CO ':?,-.1*:.;'''"-X47.1,V,,''t ,,i-,•';,,,r*„7",
,, . ,„,...;: i. ,.7-5, 3- -c,,f7,:-0.:
Other land (2) 't, Zrtf1. ,
Total land(final plus line 2) (3)
ti.:.. z,,,,,,, --,34.-y.--.44. ..!-
Residential improvements or Dvariling (4)
,:,,',4i...,- .'.150,4-- ..Uir,:eZ;
annually assessed mobile!
.,==;f:4-4...,,,......-1-ei ;it.iWli.-,.!---',1_f.,:7.S.7L •
,,,-4:
manufactured home Garage (5) .;.^ir...,ft.W.74,..,-'''... .tly-7),:.
Other improvements CO --..4: -.,:-Z- IMitiligt.N.-.3
Total improvements(line 4 through line 6) (7)
Total value(line 3 plus line 7) (8)
Signature of Assessor Date signed(month,day,yew)
I hereby certify the above is true,correct,
and complete.
Verifying action-Signature of Auditor _ Date signed(month,deg year)
STANDARD DEDUCTION ALLOWANCE
20 pay 20 Lesser of 60%of the assessed value of the homestead or$45,000.
Notwithstenertng any other provision,the surn o."--7".''Ille deductions provided in tC 6-1.1-12 to a mobile home $
/hells not assessed as neat property or to a manufactured home that is not assessed as mat properly may
not exceed one-halt(f/2)of the assessed value of the mobile home or marnsfectured home.
Serrature of fitiditor , Date doped Vroath,day.yea.)
F....ekli-42: ,,,..A.-.d
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