Homestead_Knust (2) cis 'r•a CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
%* STANDARD/SUPPLEMENTAL DEDUCTIONiltio FORMHC1 2022
State Form 5473(R18/1-20)
� � Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for filing instructions.
NOTE:Telephone,Social Secunly,driver's license,state identification and federal identification numbers are confidential under IC 6-1.1-12-37.
CERTIFICATION STATEMENT
I(We) (Passed)Knust, Robin 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 Homestead Property Tax Standard
Deduction is hereby claimed on the date this application is signed, (date of signature). I(We):
QJ 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.
Recorder's office where contract is recorded Record number Page
PROPERTY DESCRIPTION
County Township Taxing district(city,town,township)
CA SN O C 2,0 e
Parcel number 1 Legal description Ispetty in question: El•,,'v_-I Real propertyAnnAnnuallyassessed mobile home(IC 64.1-7)
If any portion of the residential structure or the land not exceeding one(1)acre that immediately su nds at structure is used to produce income,describe the use and portion
of the property utilized to produce income.
,( _ oLt - s---_ 400 _ 000 . S53 - 02,0
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State,County,and Township Is claimant v h a homestead?
k. 44,,A. -(-
❑ Yes
IW No
I hereby certify the above statements are true,correct,and complete.
Addre contact(number and street,city,state,and ZIP rode) Address of vacated homestead,if any(number and street,city,Nate,and ZIP code)
gok S Old Qaila)'v. R-ck Q kk-fir\-t.l 1666
ASSESSOR USE ONLY ASSESSED VALUE I HOMESTEAD VALUE I NON-RESIDENTIAL
VALUE
Landrrnot exceedingre ide one m acre immediately (1)
surrounding residential improvements I
Other land (2)
Total land(line 1 plus line 2) (3) L Pr)
Residential improvements or Dwelling (4) O1
annually assessed mobile! 0 K b
manufactured home Garage (5) Or1�
Other Improvements (6)
Total improvements(line 4 through line 6) (7) 43488 p
Total value (line 3 plus line 7) (8) N CO(/NT 4.
I hereby may the above is true,correct,
Signature of Assessor Date signed(month,day,ye
and complete.
Verifying action-Signature of Auditor Date signed(month,day,year)
STANDARD DEDUCTION ALLOWANCE
20 pay 20 Lesser of 60%of the assessed value of the homestead or 545,000.
Notwithstanding any other provision,the sum of the deductions provided in/C 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 exrzl one-half(1/2)of the assessed va/i(///C���a\M1t(1e mobile home or manufactured home.
Signature of Auditor ry/l'w U� Date k i�d� th,da-o .y z- '
DISTRIBUTION: Original-County Auditor.File-Stamped Copy-Taxpayer '^fir Z
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