HomeMy WebLinkAboutHomestead_Townsend (8) ,...r•,a CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
Riot.. STANDARD/SUPPLEMENTAL DEDUCTION ��l �%
° State Form 5473(R18/1-20) HC10 ,.�C�
•
. 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/C 6-1.1-12-37.
�'" CERTIFICATION STATEMENT
I(We) - e �1 M LADY e \vf f _ certify that I(we)occupied as my(our)principal
place of residence or am(are)buying the following described real property under contract for which a Homestead Property Tax Standard
Deduction is hereby claimed on the date this application is signed, (date of signature). I(We):
N.Own, ❑ 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
County G Township O n S r Taxing district(city town.township)
Parcel number J`�r Legal description l/—uJ( Is t operty in question:
Real property ❑ Annually assessed mobile home(IC 6-1.1-7)
If any portion of the residential structure or the land not exceeding one(1)acre that immediately surro de t t structure is used to produce income,describe the use and portion
of the property utilized to produce income.
es—
PROPERTY OWNED ELSEWHERE BY CLAIMANT ---
State,County.and Township Is clai nt vacating a homestead'? t —
Yes ❑ No 1
Signature of claimant CD
I hereby certify the above statements are true,correct,and complete. G�
Address f contact(number an Siree city,state,_a d IP code) Addressd homestead,if-ny(number end st t ty state.and ZIP code) `/--)
212 w •\e Lit c '-. .�-. Nt1- LI--61 2 W ten•• a
ASSESSOR USE ONLY I ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL f1
VALUE
Land not exceeding one(1)acre immediately (1) .: -
surrounding residential improvementsOther land (2) - - - - —_
Total land(line 1 plus line 2) (3) W
Residentialof mobile or Dwelling (4) FILED
..„
�: Nannually assessed mobile/
manufactured home Garage (6) _. . )
Other Improvements (6) ,[F'7Aa �-Al v
Total Improvements(line 4 through line 6) (7) MAY 2 4 2022 c\-)
Total value (One 3 plus line 7) (8)
- _-- Signature of Assesso( ,g / � Date signed(month,day,year)
1 hereby certify the above la true,correct, 7,l�LrGG, JI/Rirl'
and complete. f�/� ' ) ---
---- -_--Verifying action-Signature of Auditor GIBBON COUNTY 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 ho or manufactured home.
Signature of Audit 1 �' GJ 1 Date si (month.day, a_ r) ^�
DISTRIBUTION: Original-County Auditor.File-Stamped Co -TaRpa/ ZLl "'T�:,^J L -
Page 1 of 2
CY40 ASt_D-",'.a_ 1 2-3 she.\s r . -(0,.A,3 1( ,Nt ht,,_ .e___ 2I-Z w 4e,c, k -