Homestead_Howland CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
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tt STANDARD I SUPPLEMENTAL DEDUCTIONIllitFOROR I2Z- 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.
10ERTIFICATION STATEMENT
I(We) L!t ZA,02 0,-. F- I-4UsJ(`,.�.,,-•l( 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 Homestfead
Propertyatur I Tax Standard
Deduction is hereby claimed on the date this application is signed, t;//9/0��
(We):
Qosetun 0 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.
CLAIMANT'S INFORMATION T lap ne number of claimant
CONTRACT RECORDED
If buying on contract.Fee Simple owners name
Record number Page
Recorder's office where contract is recorded
PROPERTY DESCRIPTION
County Township Taxing district(city,learn,township)
Parcel number Legal descnption I Is the(property in question.
afo-lon-kll
IyR62i property 0 Annually assessed mobile home(IC 6-1.1-7)
If any portion of the reside A3-GAO'. `.fo3-off ntial structure or Ne 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
PROPERTY OWNED ELSEWHERE BY CLAIMANT
Is claimant vacca�ttiingg a homestead?
State,County.and Township ❑ Yes r.�
Sign. r.f clge"ma /
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I hereby certify the above statements are true,correct,and complete. / r / 9:71411&err ___
Address of contact(number and street,city,state,and ZIP code) Address -rated homestead.if any(number and street,city,state.and ZIP code)
I
NON-RESIDENTIAL
ASSESSOR USE ONLY ASSESSED VALUE I HOMESTEAD VALUE VALUE
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Land not exceeding one(1)acre immediately III) _ _
surrounding residential Improvements - ------
Other land (2) - --- - _� -
Total land(line 1 plus line 2)
Residential improvements or
(3)
Dwelling ■I- my ./...- - - - -- -
annually assessed mobile/ Garage
manufactured home 1--p
_—. (6) ,.n'z 7 ii`-'' '.-V"'" �
Other Improvements AUG
Total improvements(line 4 through line 6) (7)
Total value (line 3 plus tine 7) (8) �jn---
Signature of Assessitazia. -_-) Date signed(month,day,year)
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I hereby certify the above is true,correct, CIBSON Cn NTY AUDITOR
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 $
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�'f/�M@�\obile home or manufactured home. Dame monM, ay.year) Als
Signature of Auditor �/_ C ( IA�1 4\ Y C- --'
I DISTRIBUTION: Original-County Auditor.``'1 •File-Stamped\Copy J)-Taxpayer Page 1 0f 2 V-�'' VV
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