HomeMy WebLinkAboutHomestead_Dersch (2) � ptt,, CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
ai_ STANDARD18 ) HC10 SUPPLEMENTAL DEDUCTION ;
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..--„,,,,,:y 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.
'CERTIFICATION STATEMENT
I(We) ilik e_l E. &-n(. . "De..r. c.k. certify that I(we)occupied as my(our)principal
place of residence or am(are)buying the following described real property under contract for which a Homestead Property Tax Standard
Deduction is hereby claimed on the date this application is signed, .S - 2- 3 (date of signature). I(We):
❑ Own. • 0 Am(are)buying under recorded contract.
0 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.
0 Am (are)the shareholder, partner, or member of the entity that owns the property.
• . _ --_-_,;;;
PROPERTY DESCRIPTION
County Township Taxing district(city,town,township) _^
Parcel number . Legal description 'Is the prope in question:
eel property 0 Annually assessed mobile home DC 6-1.t-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
AlQ .. 1t.--s,- ` g, ~ - ou- -- coo . ` q " 07
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State,County.and Township Is claimant vacating a ho estead?
❑ Yes [A
Signature of claim nt \ç-\
I hereby certify the above statements are true,correct,and complete. X
Addresss of contact(number and street,city state,and -(/-coode) (���} Address of vacated homestead,if any(number and street,city,state.and ZIP code)
t � ' �J ` ' �D C
ASSESSOR USE ONLY I ASSESSED VALUE ( HOMESTEAD VALUE NON-RESIDENTIAL
VALUE
Land not exceeding one(1)acre immediately (1)
surrounding residential improvements )[•'ti M1
Other land (2)
Total land(line 1 plus line 2) (3)
Residential improvements or Dwelling (4)
annually assessed mobile I rq (* .
manufactured home Garage (5) ^YY. ;_ ' ,
Other improvements (6) I.I... 2023
Total improvements(line 4 through line 6) (7) eSo -
t 4.7
Total value (line 3 plus line 7) (8) (:0 - i }
i hereby certify the above is true,correct, • Signature of Assessor Datc ey da,y
and complete. yi',y
Verifying action-Signature of Auditor Date signed(month,day.year)
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(1/2)of the assessed value of the mobile home or manufactured home.
Signature of Auditor Date signed(month,day,year)
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DISTRIBUTION.Original-County Auditor,Pile-Stamped Copy-Taxpayer
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