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Mobile Home_Monroe 21, ., CLAIM FOR HOMESTEAD PROPERTY TAX YEAR• STANDARD/SUPPLEMENTAL DEDUCTION FORM it c HC1O State Form 5473(R181 1-20) 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) ' I a• gincertify (we)occupied ( )P principal _ +��� �� e that I as myour rinci al place of resi.- --or am(are)buying the following described r--I p•p-- under contract for which a Homestead Property Tax Standard Deduction is hereby claimed on the date this application is signed, /&'/a (date of signature). I(We): PI 0 _`( I L Wtwn ❑ Am(are)buying under recorded contract. rJ 11 ❑ 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. ❑ Am (are)the shareholder, partner, or member of the entity that owns the property. If buying on contract,Fee Simple owner's name Recorder's office where contract is recorded Record number Page PROPERTY DESCRIPTION County Township r Ta g dist\ct(city town.township) mli D G,b_ �y, Z� r�,f\�ta� _, Parcel number Legal description Is the property in question. -ex-tie* ow53-co ❑Real property nnualty 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 A/649 2022 of the property utilized to produce income — gag- o5ay11-60 a..1� ) • PROPERTY OWNED ELSEWHERE BY CLAIMANT 'UDITOR State.County.and Township Is claimant vacating a homestead? ❑ Yes UP-No Signature of claimant r I hereby certify the above statements are true,correct,and complete. killen - 1 Address of cool ct(number and street.city state.and ZIP code) I � Address of vacated homlestea if any(number and street,city state.and ZIP code) Gy3 l Cl-� ( �ncefon �N `17 , d ASSESSOR USE ONLY I ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL VALUE Land not exceeding one(1)acre immediately l t) i:.:i., i,E:• aN-''•n,. ..,,.a7. surrounding residential improvements _ Other land (2) ..,..,'.a. k Total land(line 1 plus line 2) (3) Residential improvements or Dwelling (4) ' annually assessed mobile/ - - - - 'e1er'"'t'•"s'- manufactured home Garage (5) Other improvements (6) �3 g > i lib:. Total improvements(line 4 through line 6) (7) Total value (line 3 plus line 7) (8) -- I hereby certify the above is true,correct, Signature of Assessor Date signed(month day year) and complete. Ventymg 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 645,000. 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) ,' 1/4.) era VD 4 DISTRIBUTION: Original-County Auditor,File-Stamped Copy-Taxpayer Page 1 of 2 --- • o� ,,.�, MANUFACTURED (MOBILE) HOME PERMIT i �]6 _________4 T .- : - - - -,, i -C3.`a the t-aoi`,f8"ra;a, =a::: a - - - • K/ NOTE! _ . t: .s: a -,._ = i_: . .- _ . _� . , . -:: e _ _- ,. _ re . -- -- ----------- ATTENTION: MOVER.HAULER,OR TOWER A E,e-3o .,-:> >ercage=i ._. 7.5_ LC• H7 - i `7C C-s, .ice C' ---, ,. ., _» . c : - - 7- .. - • -. ---- - ---- ---- ----- -- --- -- - O ti•ni .J ! .r- SECTION A-MOVING PERMIT o +k'�. �t m' Apor ,1.� '• is ,. ��- (t. ':• -" CLAIM FOR HOMESTEAD PROPERTY TAX YEAR r) :.., STANDARD I SUPPLEMENTAL DEDUCTION FORM :4 •,, „ State Form 5473(R19/1-23) HC10 in,,,,, '�' Prescribed by the Department of Local Government Finance (,II' 1 p,",1.l,',+ INSTRUCTIONS:See reverse side for filing instructions. +I tt NOTE:Telephone,Social Security,driver's license,state Identification and federal Identification numbers are confidential under IC 6-1,1-12-37. `'I I !'"+.., t CERTIFICATION STATEMENT {I�'S i 41'111,,, I(We) ' ' w/ r��=j certify that I(we)occupied as my(our)principal place of ;' 1 r�: 1,. residence or- q(are)buying the loll s b reJ�t rty under contract for which a Homestead Property Tax Standard Deduction Is hereby claimed on the ',';}'Iy.q, . '' �dt•L,,1'• date this application is signed, tr7 '� V (date of signature).I(We): 1 • 1 l ' +',,'WI h E Own. ❑Am(are)buying under recorded contract. i 1 •i , I I,' ❑Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation. . r i' I t 'I.,.; ❑Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified personal residence trust. •1 "i 1 11,I i. ❑Am(are)the shareholder,partner,or member of the entity that owns the property. '1 1 r i I �: i W--(t \,,)Recorder's Office Where Contract is Recorded Record Number Page 'L{� ;p PROPERTY DESCRIPTION '' i Count Township �r ^ s7 Taxing Distrt rly,tawn_to shi © w � (jJ(G.�.j`(�J(` rjtJ.Fr�fj\,tj G�"'�J. 11 r {'i P° Parcel Number Legal Description Is the property in question: 1'1! ❑Real Property XAnnualy Assessed Mobile Home(IC 6-1.1-7) If any portion of the residential structure or the land riot exceeding one(1)acre that Immediately surrounds that structure is used to produce income,describe the use and portion •k of the property utilized to produce income. li PROPERTY OWNED ELSEWHERE BY CLAIMANT State,County,and Township Is Claimant Vacate Homestead? CI Yes No Signatur f Claimant I hereby certify the above statements are true,correct,and complete. 41 �,t, Address o�pnta number and stree rate,an�2tf>i_�e)_ �j ) �� Address Vacat Homestead,if any(number and sheet,city,state,and ZIP code) 40 kJ ASSESSOR USE ONLY C ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL VALUE Land Not Exceeding One(1)Acre Immediately (1) E': ; Surrounding Residential Improvement Other Land (2) .,�y =, + T Total Land(line 1 plus line 2) (3) Residential Improvements or Dwelling (4) 1 Annually Assessed Mobile/ A Manufactured Home Garage (5) Other Improvements (6) n Total Improvements(Line 4 through Line 6) (7) % 0��� r ►�/ Total Value(Line 3 plus Lena 7) (8) t^ ,,A4 ) Signature of Assessor Date Siggnefll((te, ear) I hereby certify the above is true,correct,and complete. ,q� Verifying Action-Signature of Auditor Date Signed(date,month,,‘, STANDARD DEDUCTION ALLOWANCE 20 Pay 20 Lesser of 60%of the assessed value of the homestead or$48,000. Notwithstanding any other provision,the sum of the deductions provided in 1C 6-1.1-12 to a mobile home that $ is not assessed as real property or to a manufact home that is not assessed as real property may not exceed onq<half(1/2)of the asse value of t a mobile home or manufactured home. /�� L Signal e f Audi or �/(�� f F Date�Signe ( Q�h O'-t of E) DISTRIBUTION: Original—County Auditor,File-Stampedyl%Copy—Taxpay¢r�7 C}/q di,,, Page 1 of 2