Homestead_Bishop (4) CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
Elket, STANDARD/SUPPLEMENTAL DEDUCTION FORM
State Form 5473(R18/1-20) HC1G r?�2 _
rs - 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.
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I(We) certify that la(we)occupied as my(our)principal
place of residence or am(are)buyin the following described real propertyy[( wont ct form ich Homestead Property Tax Standard
tion is hereby claimed on the date this application is signed, (V K7�1/Q 7 Z (date of signature). I(We):
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.
If buying on contract,Fee Simple owners name
Recorders office where contract is recorded Record number Page
PROPERTY DESCRIPTION
County Township Taxing district(city,town,township)
,SJ 1'1 022 •
Parcel number, \ Legal description Is t party in question:
�IVJ 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 sun-os ds t structure is used to produce income,describe the use and portion
of the property utilized to produce income.
— 12-01- - ( -0 D_ � 0 5"---- -028 •
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State,County,and Township Is claimant va'ing a homestead?
❑ Yes ►1 No
Signature of claimant
he b tements are true,correct,and complete. X a' ( Nil
'
Address of contact. (number and street,city.
state,and ZIP code) p ' ` Addr of vacated homestead,if- y tuber and street.city state.and ZIP code)
►l LW2� i1��l ' S1 r !`--f1
•
ASSESSOR USE ONLY ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL
VALUE
Land not ex�Pedi a 1)a_crg]Immediately (1)
��. SlyLate-r jr�d yQS P/iRJm te entB _—
GIBRi3fikr1 -INTY AUDITOR (2)
Total land(line 1 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) (6)
1 hereby certify the above is true,correct,
Signature of Assessor Date signed(month,day,year)
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$45,000.
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 exceed one-half(12)of the a value of the mobile home or manufactured home.
Signature of Auditor / � Date sigr ed(mon day,Ye
DISTRIBUTION:Original-County Auditor,File-Stamped Copy-Taxpayer g
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