Homestead_Luttrell CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
:t__ .+- STANDARD I SUPPLEMENTAL DEDUCTION FORM
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�� Sate Form 5473(R15/614) HC10
\ n• Prescribed by the Deparmnent of Local Goven anent Finance
INSTRUCTIONS:See reverse side for filing instructions.
NOTE:Telephone,Social Securiy,drivers license,state identification and federal identification numbers are confidential under IC 6-1.1-12-37.
w/-. - - '�""•�CERTIFICATION
I(We) / I e /1 1 r='/ cacti c a l 1-e)'•.. pi::.x.`in f s principal•place of residence or am(are)buying the following described real property under contract fo ` ich 4•i- -a• •ro -; =Standard
Deduction is hereby claimed on the date this application is signed. (date of signature. e):
❑ Own. ❑ Am(are)buying under recorded contract. FEB 3 2015
❑ Mn (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 - •ualified personal residence trust
❑ Am (are)the shareholder, partner, or member of the entity that owns the property. ,/
_n: -__ _P-. .:CLAIMANTS INFORMATION S. 11:,afa rats.; _j i✓-Xs.t.'J
—v-.._Y
If toying on contact.Fee Simple owners name
Recorders c:.ce where contract is recorded Record number Page
a =:».: 'z .t/.:.>>- .:-:ISA PROPERTY DESCRIPTION - ; ::r?:;<r--E`t-stis'-vin:',
County Township lace(city,to•� )) T
201.4 //al/
Parcel number Legal description Is the property in question:
eal property ❑Amualy assessed mobffe borne(IC 64_1-7)
If any portion of the restlwsal stu=re or the land not exceeding one(I)acre that immediately surrounds that stuawe is used to produce income describe the use and portion
of Pe property traced to produce thane.
a1 —i 9_/ --/o / — oo h- /tali oa
PROPERTY OWNED ELSEWHERE BY CLAIMANT
Sate,Gassy,and Township Is claimant vacating a homestead?
❑ Yes ❑ No
Signature of imam
I hereby certify the above statements are true,correct,and complete. u 44 f'D
Address of contact(number an].Cmet,day,state,end ZIP code) Address of vacated Nynex:ea&If any(number end sbeef city state,and ZIPcode)
X 9/a? C4 / c ea Sa La hr. icraca c 2NV7t V
Land not exceeding one(1)acre immediately h)
surrounding residential improvements
Other land (2)
Total land(line 1 plus line 2) (3)
Residential improvements or Dwelling I(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) (5)
I hereby certify the above is true,correct, 5gha:ire of Assessor Date signed(month,day,year)
and complete.
Yedyvg argon-Signature of Audlor I.• ay.Yea/I
-+'— t--i._'- --ESTANDARD DEDUCTION ALLOWANCE'- s)C. tifi:-•".aw"ff'�'--`:a...4 -mod,'
20 pay 20 Lesser of 60%of the assessed value of the homestead or$45,000
Nohsithstanding any other provision,the sum of the deductions provided in IC 6-1.1-12 to a mobile home 5 FEB 3 2015
that is not assessed as real property or to a manufactured home that is not assessed as real property may
not exceed one-half(1rz)of the assessed value of the made home or manufacured home.
Sgnabu .IMil_,'J _ i .f GIB • �Iat
DISTRIBUTION:
Original-CounyAua:or.Re-Stamped Copy-Taxpayer
` CLAIM*FOR HOMESTEAD RROPERTY TAX
� CREDIT/STANDARD DEDUCTION
\ State Fwm Sa73 (R614-03)
' � Presaibed by Ne Departmeni of Local Govemmeni Finance
INSTRUCTlONS: See �everse side lor filing instruc6ons.
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I(VJe) ocwpied es our prindpal place of esidence tha tollowing described real
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forwhich a
FORM
HC10
YEAR
�I(VJe) owned ❑ Are buying under contrect MAY 5 2005
II`ve a benefidal interest in the enUry that is liable for Ne properry taxes on the properry and that owns the property or is buying under a convact.
If Miy4ig on contrect, Fee Simda ownafs name
Recwtlefs offlce where conVect Is remrded
Tavnship
Lepal dewiption
Ta�ing district (ci7y, town,
If any poRion o( ihe residential sWGUra w the IaM not e:caeding ona (1) aae ihat immediately surtounds
ot Ne rty uillized uce inwme.
pj�-QI��-0�
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Recortlnumber �Page
MobOe Home (I.C. 6-1.
is used ro produce income, describe the use and portion
20_Pay20_
Lesser of tf2 Homestead
� Valualion a $35,000
Date�� �