HomeMy WebLinkAboutHomestead_Brown (14) - e -,•,,,, CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
• t STANDARD,/SUPPLEMENTAL DEDUCTION �I-
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.� _ - - HC10
State Form 5473(Rt8/1-20)
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•" ‘ Prescribed by the Department of Local Government Finance ` �(� _ •
INSTRUCTIONS:See reverse side for filing instructions. i_]\Ul ir)
NOTE:Telephone,Social Security.driver's license,state identification and federal identification • -- -a• -- Idential under IC 6-1.1-12-37.111110
CERTIFICATION STATEMENT
I(We) t I��Q -7- Jr certify that I(we)occupied as my(ou pp al
place of residence or am(are)buying the following described real property under contract for which a Homest Property Tax Stan/AI-Orbit?
Deduction is hereby claimed on the date this application is signed, (date e).e). I(We):
Own. ❑ Am(are)buying under recorded contract. SON Cp
m(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation. LINTY
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified personal residence tru 0i
❑ Am (are)the shareholder, partner,or member of the entity that owns the property.
Social Security number of claimant's spouse(last five digits) Driver's license/Identification/Other number of claimant's spouse(last five digits) Issuing State
(Applicable only if applicant's spouse does not have a social security number.)
CONTRACT RECORDED
If buying on contract.Fee Simple owners name
Recorders office where contract is recorded Record number Page
C ty Township •Taxing district(city town.township)
v
P number Legal description Is the property in question:
El Real property Annually assessed mobile home(IC 8-1.1-7)
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.
PROPERTY OWNED ELSEWHERE BY CLAIMANT
• State,Court- /JJ�� +- / Is claimant vacating a homestead?
��/V (�/ ,r/n c�T`"� 1D 7� ❑ Yes Q No
Signature of Im nt
I hereby certify the above statements are true,correct,and complete. `!K!`
Addr s of contact(number and street.city,state.and ZIP code) Address of vacated homestead,if any(number end street,city,state.and ZIP code)
VD 6c 5 -f /rl G 1-ei'i r�
ASSESSOR USE ONLY I ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL
VALUE
Land not exceeding one(1)acre immediately (t) - -
surrounding residential improvements - • - ---
Other land (2)
Total land(line 1 plus line 2) (3)
Residential improvements or Dwelling (4) '�"•• f "'
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)
Signature of Assessor Date signed(month,day.year)
I hereby certify the above Is true,correct,
and complete.
Verifying action-Signature of Auditor Date signed(month,day.year)
9
STANDARD DEDUCTION ALLOWANCE
.1 20 pay 20 Lesser of 60%of the assessed value of the homestead or$45,000.
(
f ID Notwithstanding any other provision,the Sum of th deductions provided in IC 6-1.1-12 to a mobile home $
J that is not assessed as real property or to a menu ctured home that is not assessed as real property may
not exceed one-half(1/2)of the assessed valu I the mobile home or manufactured home.
•
Signa l/4Ttlitor Date signed(month,day,year)
1 DISTRIBUTION: Original-County Auditor.File-Stamped Copy-Taxpa /��l
Page 1 of 2 71
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