Homestead_Curry (3) ,.•�•:ro CLAIM FOR HOMESTEAD PROPERTY TAN FORM--
?/ t` STANDARD ISUPPLEMENTAL DEDUCTION IL Hcro a
Stale Form 5473(R18/1-20)
Prescribed by the Department of Local Government Finance
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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.
I(We) Ilre:24./-e• 9( dor certify that I(we)occupied as my(our)principal
place of residence or a )buying the following described al property under contract for which a Homestead Property Tax Standard
Deduction is hereby c med on the date this application is signed, (date of signature). I(We):
7C❑
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.
0 Am (are)the shareholder, partner, or member of the entity that owns the property. `
If buying on contract.Fee Simple owner's name
Record number Page 1
Recorder's office where contract is recorded
PROPERTY DESCRIPTION
Co . Township Taxing district(city town,township)
irw::14)
' J.
Legal description ---- - _- - Is the pcstssctureis
erty in question'.
Pa I tuber l i/�
(/Q Qf.. .300- 0L/r� O immediately s th used to produce in ,describe the use and portion(4
of the property utilized to produce income G/e
SON CO(JN G J
r/E 67-40
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State,County.and Township Is claimant vacatir5 a homestead?
❑ Yes 8'No
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Sign. re - ,t
I hereby certify the above statements are true,correct,and complete.
Address of contact(number ind street,city state.an.-ZlP code) A • - I vacated homestead.if any(number and street,city state,and ZIP code)
ASSESSED VALUE I HOMESTEAD VALUE NON-RESIDENTIAL
ASSESSOR USE ONLY VALUE
Land not exceeding one(1)acre immediately (t) _
surrounding residential improvements ,------ ----- - -
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Other land (2) 1'
Total land(line 1 plus line 2) (3)
Residential improvements or Dwelling (4) '�`M s,r_,1'.,;.,r �,ir ,
annually assessed mobile I Garage (5)
manufactured home _ ,,'
Other improvements (6) i ,'"" i`xtg-. t k�f
. 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 certify the above Is true,correct,
and complete.
Date signed(month,day.year)
Verifying action-Signature of Auditor
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 S
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. — Date signed(month,day.year)
Signature of Auditor , - / 2e.
—�—•-7 O 2-2
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DISTRI6 DON: Original-County Auditor,File-Stamped Copy-Taxpayer
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