HomeMy WebLinkAboutHomestead_Comer I
CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
I
4- CLAIM FORM 1
'IA* STANDARD/SUPPLEMENTAL DEDUCTION 2aZZ
4, State Form 5473 0218 t 1-20) __
Prescribed by the Department of Local Goremm•nt F.nance ticta
INSTRUCTIONS:See reverse side for hOng,nsfr•chops
NOTE Telephone,Sooni Security,driver's license,state rdenbhcaton and federal:dentthCahon numbers are Conhdenoa!under IC 6-1.1-12-37.
�A CERTIFICATION STATEMENT
I e) 1 I L MGt _ __certify that I(we)occupied as my(our)principal
place of residence or am(are)buying the following described real propery alndgr tractr�Orwhich a Homestead Property Tax Standard
rn
Deduction is hereby cfoed on the date this application is signed, IC/,oV `L • (date of signature) I(We).
,KOwn ❑ Am(are)buying under recorded rcontract
Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation.
LA Have a beneficial interest In the trust or the right to occupy the property under the terms of a qualified personal residence trust.
U Am(are)the shareholder, partner.or member of the entity that owns the property
CLAIMANT'S INFORMATION
CONTRACT RECORDED 1
If buying on contract.Fee Sumps.owner's name
Record number Pegs
Recorder's Rc where contract os record.
PROPERTY DESCRIPTION
County Tewrrahrp Taring mat,.(err.town,O ,
Sow '� ' si . RRteee .
Parcel
u Parcel nns.t Legal closedown is 111R���tteeepppppprorororororoPetty in du.stwn' rr *sinuosity
Reel property ti *sinuosmob.ty assessed nob hone.(IC 6-f f-7)
If any poretn of the r.eld.ndal structure.0 the Iend not...mg one(11 acre that irnm.dubty surrounds t structure is used to produce inconr.describe the use and portion
of the property utilized to produoe.looms
tu b - I l - I LI - 0 a - C a .3 . a-9--11 - 0 a-
PROPERTY OWNED ELSEWYERE BY CLAIMANT
Slate County.end Townenp Is claimant vak[yM4 a homestead'?
Iu Yes No
— S.gnatwa of rdearu t
I hereby certify the above statements are true,correct,and complete.
Address of contact owns.,and(treat my sta.and ZIP coda) .... Addrwas of vaeared nome.aad'I any fnumt.,and ttmet cry out.and zlecnde)
1 u3 F't Q 1-'.0,,,--yn-Li3640 .
` HOMESTEAD VALUE NON.RESIDENTIAL
ASSESSOR USE ONLY ASSESSED VALUEVALUE ..T/■
L
Land not exceeding one(1)acre Immediately (t1
surrounding nsld.ngalimprovements _— ----
Other land (2) ,. a -- � `. _
Total land((fire 1 (3)plus fine 7) »»,
g
Residential Improvements or Dwelling psi 22
annually mobile I Clomp (5)
manufactured horn.
Other Improvements ..._ (8) r,. x .'s....�.x:. �/ ;, `. ,
Total Improvements(fine 4 through fine s) l7) ,_ DITOR
Total value Woe 3 Pro fine 7) (8)
Signature of Assessor Date aimed(mon..day years
I hereby certify the above is true.correct,
end complete. Dew signed M..,day manVerify.;ar�wt-Signature of/Wator
STANDARD DEDUC TION AL I.OWANC t-
pay 20 Lesser of 60%of the assessed value of the honrostead or 545.000
20
mar is a t as a aanyssessed
s re l property
the sow of theu a Lured home
s F that tsd orof hC o f f d a to a moor a tome ( 5
Mat is/f W aaaellaad N herd or to a manufactured home that IS not assessed as real Property may
nor exceed one-halt(112)of the assessed value ale home or manufactured home —...__i_. "-.___ rf
...._____ ones ( ''Pr(/yi^r"'Jl l_
Sgn. r•01 Ar.dax , \�
DISTRIUTICN:Odgittel-County Autlaer,Fite-Stammd Cepv- .pay.
Page 1 of 2