HomeMy WebLinkAboutHomestead_Kiesel (4) CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
a. FORM �^ r7
° � STANDARD/SUPPLEMENTAL DEDUCTION HCIO LC_
s State Form 5473(R18/1-20)
-= Prescribed by the Department of Local Government Finance
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.
I(We) x _ _certify that I(we)occupied as my(our)principal
iplace of r sidence or (are)buying t e following described real property under contract for which a Homestead Property Tax Standard
Deduction is hereby c aimed on the date this application is signed. (date of signature). I(We):
Z 'n ❑ 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.
)
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 Taxing district(city town.township)
r —
Parcel number al irepti / c Ii the property in questioziogie n.
❑Real property ❑ Annually assessed mobile home(/C 6-1.1-7)
If any portion of the residential structure or the land not excee g 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
.26 -, / 9 - 3/ - Joel - 000 . 5/ s _oo2
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State,County.and Township Is claimant vacating a homestead?
❑ Yes ❑ No
Signature of claimant ,/
I hereby certify the above statements are true,correct,and complete. C. Ire h^ / , ! / !-,C
Y Address of contact(number and street.city,state,end ZIP code) Address of vacated homestead.if any(number and street.city state,and ZIP code)
_ /( h -
ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL
ASSESSOR USE ONLY 1!ALUr
Land not exceeding one(1)acre immediately (t)
surrounding residential improvements
Other land (2) J l} irr- ..
Total land(line 1 plus line 2) (3) --
-
Residentialimprovementsor Dwelling (4) wtr
-----_—-- -�- _..-- l.i ...a..c w'e u
annually assessed mobile/ — 4
manufactured home Garage (5) -' - '
Other improvements (6) _ .. fa 4`A',_
.. Total Improvements(line 4 through line 6) (7) -----..Total value (line 3 plus line 7) (8)
Signature of Assessor Date signed(month,day.year)
1 hereby crtify the above is true,correct,
and compelete. Date signed(month,day.year)
Verifying action-Signature of AuditorT T
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 $ MAY 1 ,0 2022
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 mobile home or manufactured home.
Signature of Auditor .. Datesi a (month,day,year
/-� °)
�,IrsSUN COUNTY AUDITOR
DISTRIBUTION: Original-County Auditor,File-Stamped Copy-Taxpayer
Page 1 of 2