Homestead_Henehan •s-••A CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
t STANDARD/SUPPLEMENTAL DEDUCTION FORM
State Form 5473(R18/1-20) HC10 2022
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. Ib
CERTIFICATION STATEMENT
I(We) Henehan, Ryan Joseph/Ashley Laine 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 Sta.guard
Deduction is hereby claimed on the date this application is signed, (date of signs . I(We):
l71 Own. D Am(are)buying under recorded contract. Oho.. I r9?O
'46
El Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation. Q� ?<""
0 Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified personal resrll@.iecit.
El Am(are)the shareholder, partner, or member of the entity that owns the property.
Recorder's office where contract is recorded Record number Page
PROPERTY DESCRIPTION
County Township Ta g district town.tz!_vy nship) f/
Parcel num\ Legal description Is thee pro in question:
I�I Real rty El Annually assessed mobile home(/C 6-1.1-7)
If any portion 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.
14T - 008 -00 - 4- - 3
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State,County,and Township Is claimant vacating a homestead?
El Yes ® No
ture of claimant , r�
I hereby certify the above statements are true,correct,and complete. 11
Address of contact(number and street,city,stare,and ZIP code) Address o vacated ho 9--e a,1 ,/�!/�r v/\
ny(number and street,city,state,and ZIP cede)
5406 E SR 56, H'ton, IN 47640
ASSESSOR USE ONLY ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL
VALUE
Land not exceeding one(1)acre immediately (1)
surrounding residential improvements
Other land (2)
Total land(line f plus line 2) (3)
Residential improvements or Dwelling (4)
annually assessed mobile/
manufactured home Garage (5)
Other Improvements (6)
Total Improvements(line 4 through line 6) (7)
Total value (line 3 plus line 7) (8)
I hereby certify the above Is true,correct, signature of Assessor Date signed(month,day,year)
and complete.
Verifying action-Signature of Auditor D. • -- ••• th,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 lC 6-1.1-12 to a mobile home S JUL j (l 20,,
that is not assessed as real property or to a manufactured home that is not assessed as real property may e7
not exceed one-half(1/2)of the assessed value of - •-'e home or manufactured home.
Signature of Auditor s' (month,day,year)
pinlr�ch�V G► sON �
AUDIT
DISTRIBUTION:Original-County Auditor,File-Stamped Cop r0� OR
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