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Homestead_Bachman (2) ��^x�a CLAIM FOR HOMESTEAD PROPERTY TAX YEAR �1 STANDARD I SUPPLEMENTAL DEDUCTION FORM • • State Farm 5473(R16/1-20) HC10 24)Z3 , � Prescribed by the Department of Local Government Finance , place of residence or am(are)buying the followingdescribed real roe under contract for which a Homestead Property Tax Standard Y 9 property�Y P rtY Deduction is hereby claimed on the date this application is signed, —q.c:Dvof3. (date of signature) I(We): t( Own. El 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. " 4s ..-J-5 Recorder's w herd contract is recorded P.ecord number i Page I PROPERTY DESCRIPTION County Township Taxing district(city town,township) 7' (/' It-- r e—k �.r--C. r a..,r c. C, b I Parcel number + . Legal description i Is the property in ques:ian al property ❑ Annually assessed mobile home(!C 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 Ck-Q, 'P 1, - -D.k-k - Qoa----10\ •-- t-IC -CD .c) PROPERTY OWNED ELSEWHERE BY CLAIMANT State.County and Township i Is claimant vacating�a homestead? r] Yes ^ . ° Signature_of claimant g 1 I hereby certify the above statements are true,correct,and complete. / )l;a.i /� � � � �� ,�� ///1 Address of contact(nu ber.nd street.c' state and ZIP code 1 Address of vacated h`bmestead"if a number and st et,city state,and ZIP code)I ASSESSOR USE ONLY I ASSESSED VALUE I HOMESTEAD VALUE NON-RESIDENTIAL VALUE Land not exceeding one(1)acre immediately (1) • - surrounding residential improvements i Other land I(2) Total land(tine 1 plus line 2) I(3) , Residential improvements or Dwelling I(4) RD annually assessed mobile 1 manufactured home Garage (5) bill li _Other improvements I(8) ^t/ ©9 2023 3 Total improvements(line 4 through line 6) I(7) G+ 4Y14„ _ "��k, Total value(line 3 plus line 7) I(8) UN in /�� y�' .l I hereby certify the above is true,correct, Signature orgssessor Date signed(m'dYd .� "'CLJ and complete. 0/TAR 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 S45,000. 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 Dale signed(m th,day,year) /�/j -f,(\,-.04,..._,0 a -\.0..�-tL .tr,l•, rl�� - �1- Z0G. icy • DISTRIBUTION: Original-County Auditor,File-Stamped Copy-Taxpayer �'rJ \� Page 1 of 2 \ tY` ��JJJ