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Homestead_Tretter
2:7 V� .4 CLAIM FOR HOMESTEAD PROPERTY TAX YEAR ✓ a STANDARD/SUPPLEMENTAL DEDUCTION FORM y ( / s1 HC 10 � ' ` V , . State Fond y th Department SUPPLEMENTAL 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. `1`^ CERTIFICATION STATEMENT I(We) CA CA. - if• • certify that I(we)occupied as my(our)principal 1,17 place of residence or am(are)buying the following described real property under contract for which a Homestead Property Tax Standard 0 (date of signature). I(We): _ Deduction is hereby claimed on the date this application is signed, �` _r ( \`"J.:j ❑ Own. ❑ Am(are)buying under recorded contract. \ \\ ❑ Am (are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation. S� ❑ 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. •\.t— • CLAIMANTS INFORMATION \? '"Vt�. CONTRACT RECORDED If buying on contract.Fee Simple owners name Record number Page Recorder's office where contract is recorded PROPERTY DESCRIPTION County (.3Township Taxing district(city town,township) Parcel number J�� Legal descrip© I Is e pent'in question'. Real property ❑ Annually assessed mobile home(/C 6-1.1-7) onethat immediately surrou s t t structure is used to produce income,describe the use and portion If any portiony the residential structure ear the land not exceeding (1)acre O /� of the property ulilizetl to produce income (C PROPERTY OWNED ELSEWHERE BY CLAIMANT Is claimant vacating a homestead? State.County and Township ❑ Yes ID No g ae o daimam I - -. V• e above statements are true,correct,and complete. • iiiiir [Add -s •matt(nu .-r and street,city state,and ZIP code) Address of vacated ha end.if any(numb rand street.city state.and ZIP rode) N...N \ NON-RESIDENTIAL P,35ESSOR LISE ONLY ASSESSED VALUE HOMESTEAD VALUE VALUE `w zceedi••i��'7 xI 3'- mmediately (1) • ding si• r.�d- ovements --. -- IV;�y P (2) �r� / r Ian V r r1� \ D , agd�S e 1 plus line 2) (3) -^.-ddeential improvements or Dwelling (4) --- - - annually assessed mobile/ Garage (5) - - - manufactured home Other improvements (6) -- -Total improvements(line 4 through line 6) (7) Total value (line 3 plus line 7) (8) - - -- Date signed(month,day year) Signature of Assessor I hereby certify the above is true,correct, and complete. Date signed(month.day year) Verifying action-Signature of Auditor 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 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(112)of the assessed value of the mobile ho nufactured home. Date si d( th day year) Signature of Auditor '�r� C i) 0 �3 DISTRIBUTION:Original-�Auditor,File-Stamped Taxpayer � � !/�� gina Page 1 of 2