HomeMy WebLinkAboutHomestead_Barrett Reset Form
,e -t111froi CLAIM FOR HOMESTEAD PROPERTY TAX -
h� FORM YEAR
= STANDARD I SUPPLEMENTAL DEDUCTION
;4., State Form 5473(R20/ 12-24)
HC10
- Prescnbed by the Department of Local Government Finance
INSTRUCTIONS See reverse side for filing instructions
NOTE Telephone, Social Secunty, driver's license, state identifrcatlon and federal identification numbers are confidential under IC 6-1 1-12-37
CERTIFICATION STATEMENT
I (We) ... ,J._c,tC_a_ certify that I (we)occupied as my (our) principal place of
residence or am(are)buying the follow' descnbed real property under contract for which a Homestead Property Tax Standard Deduction is hereby Claimed on the
date this application is signed ► •10• (date of signature) I (We)
A Own. E 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
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, townsh
>, 0.........Z.rit—e..r'
Parcel mber • Legal Description Is the property in question
17,11 t Property Cl Annualy 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 surrounds that structure is used to produce income,describe the use and portion
of the property utilized to produce income
aLo —. 1 — . — 1 Q — 00 1 . IS? .�OOO k .
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State County and Township Is Claimant Vacating a Homestead,
' , _. Yes No
Signature of Claimant
I hereby certify the above statements are true, correct. and complete. c
. • ilk 1 / IC:A
Address of Contact(number and street. city state. and ZIP code) •ddress of Vacate• omestea.. any(number and street city state and ZIP code)
1
4 r . '' • LCI .,,its IL ' • 7 1' .4-1L0L-NCk .
ASSESSOR USE ONL'f ASSESSED VALUE HOMESTEAD VALUE 1 NON-RESIDENTIAL VALUE
Land Not Exceeding One(1)Acre Immediately (1)
Surrounding Residential Improvement
Other Land (2)
Total Land (line 1 plus line 2) (3) PILE )
Residential Improvements or Dwelling (4)
-40
Annually Assessed Mobile i
Manufactured Home Garage (5)
• OCT Q
Other Improvements (6)
Total Improvements (Line 4 through Line 6) (7) ��
Total Value(Line 3 plus Line 7) (8) G/ <<'C4 j--
Signature of Assessor O'1/'`CO {r Iiiitp ared(datI
F
)
I hereby certify the above is true, correct, and complete. LJy. /l/1
Verifying Action-Signature of Auditor Date -0 month. year)
STANDARD DEDUCTION ALLOWANCE
20 Pay 20 Lesser of 60%of the assessed value of the homestead or 548 000
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 oot...f the mobile home or manufactured home
,
Signature of Auditor yjj Date Signed ç5a( j l
OISTRIBUT1 N: Onginal-County Auditor File-Stamped Copy - Taxpayer
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