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Mobile Home_Jones (4) 00-7,.l, CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR "al STANDARD I SUPPLEMENTAL DEDUCTION OR �O2( StatePresc riFormbed by 5473the Dep(Dep/1-20) �� � anment of Local Government Finance oo {1 INSTRUCTIONS See reverse side for filing instructions 1 NOTE Telephone,Social Security,driver's license,state identification and federal identification numbers are confidential under IC 6-1 1-12-37. CERTIFICATION STATEMENT 1C(\e'' I(We) qRl c.s 0$4.-Ne s 4 n—,`.,_s I co_ MuCiNl• certify that I(we)occupied as my(our)principal © place of residence or am(are)buying the following described real propertyunder contract� for which a Homestead Property Tax Standard 1/ Deduction�� is hereby claimed on the date this application is signed, —t—t—crCa I (date of signature). I(We): U\ 1 Lai3Own. ❑ 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. ❑ Am (are)the shareholder, partner, or member of the entity that owns the property. Recorder's office where contra is reco•-• Record number Mq age d/'- 4OC 53-v d ... 20 PROPERTY DESCRIPTION Cou y Township Taxin istnct(city,town,township) 1BSQN- D bs—O c\ _ "(Li t _ r\c.c.3rOr\ , couivi A Parcel number Legal description Is the property in question: UD '.O,0 ❑Real property wally assessed mobile home(IC 6-1.1-77 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. aL2-1ta2--r�( ) 3_�0 PROPERTY OWNED ELSEWHERE BY CLAIMANT State,county,and Township Is claimant vacating a homestead'? ❑ Yes g No Signature of imant I hereby certify the above statements are true,correct,and complete. 1 Address of contact(number and street,city,state,and ZIP codA, Addr ss of vacated homestead,if any number and street,city,state,and ZIP code) ASSESSOR USE ONLY ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL VALUE Land not exceeding one(1)acre immediately (1) surrounding residential improvements cv Other land (2) Total land(line 1 plus line 2) (3) l^V\) Residential improvements or Dwelling (4) annually assessed mobile/ manufactured home Garage (5) J�� Other improvements (6) / f``\ Total improvements(line 4 through line 6) (7) Total value (line 3 plus line 7) (6) \ /\' I hereby certify the above is true,correct Signature of Assessor Date signed(month,day,year) �J and complete. 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) a.„_,Dc.. r^` s-y-coa'DISTRIBUTIO riginal-CoCountyAuditor,File-Stamped Copy-Taxpayer777 Page 1 of 2 24)Ia3 � /3e.tp ''�ffT�T MANUFACTURED (MOBILE) HOME PERMIT (Z ��' p A\ ) State Form 7878(R8/11-17) ;/ Prescribed by the Department of Local Government Finance Ii-.6 /,/L/ -,eTej f mobile home permit: [r]Section A For Moving ❑ Section B-Transferring Title (NOTE: Separate permits required if owner intends to both move ano na-star INSTRUCTIONS: 1. A mobile home may not be moved from one location to another unless the owner obtains a permit to move the mobile home from the county treasurer. 2. The Bureau of Motor Vehicles may not transfer the title to a mobile home or change names in any manner on the title to a mobile home unless the owner obtains a permit to transfer the title from the county treasurer.(IC 6-1.1-7-10) 3. A county treasurer shall issue a permit which is required to either move,or transfer the title to a mobile home if the taxes,special assessments,interest,penalties, judgments,and costs that are due and payable on the mobile home have been paid. The permit shall state the date it is issued. The treasurer must issue the permit not later than two(2)business days(excluding weekends and holidays)after the date the treasurer receives a completed permit application. (IC 6-1.1-7-10) 4. A mobile home owner who sells the mobile home to another shall provide the purchaser with the permit required before the sale is consummated. This obligation does not apply to a mobile home offered for sale at an auction under IC 9-22-1.5 or IC 9-22-1.7. (IC 6-1.1-7-10.4) A person who violates this commits a Class C infraction.(IC 6-1.1-7-14) 5. A mobile home owner must present a copy of this permit to the Bureau of Motor Vehicles when applying for title transfer if the mobile home is to be moved.a separate permit must be requested prior to moving. 6. A Form 1(Notice of Placing of Mobile Home Upon Land or Lot)must be filed with the assessor within thirty(30)days after the date of placement of the mobile home(IC 6-1.1-7-3) 7. The requirement to obtain a permit to move or transfer title to a mobile home does not apply to a mobile home that is offered for sale at auction un ie: IC 9-22-1.5, IC 9-22-1.7,or IC 6-1.1-23.5 for the transfer resulting from the auction. (IC 6-1.1-7-10(a)) 8. Documentation provided by person requesting this permit(IC 6-1.1-7-10(d)) ^ State Issued Title E Court Order BMV Affidavit of Sac or D's:to i. NOTE: A permit to move or transfer title to a mobile home expires ninety(90)days after the date the county treasurer issues it.When the permit expires,it becomes invalid and the owner must obtain a new permit. ATTENTION: MOVER,HAULER,OR TOWER A person who is engaged to move a mobile home may not provide that service unless the owner presents him with a permit to move the mobile home and the permit is dated not more than ninety(90)days before the date of the proposed move.The mover shall visibly display the permit while the mobile home is in transit.The mover must return the permit to the owner of the mobile home when the move is completed. IC 6-1.1-7-11 Name of owner's agent,if there is an agent acting on the owner's behalf Agent's telephone number ( ) SECTION A-MOVING PERMIT rof owner I Date of issuance of permit(month,day.year) Address(number and street.city.state and ZIP code) Date permit expires(ninety(9'a)days after issvancel Make of mobile home I Year Dimension 7 Vehicle identification numbe' Address of present location(number and street,city state:and ZIP code) Affected parcel number Address cf new location(number and street,city.state,and ZiP code) Contact telephone number ( ) i SECTION B-TITLE TRANSFER PERMIT Name of owner Previous owner's telephone number I New owners telephone number Gmec jbnes �Or- Lee-CSic�/A4e,h/tciLier ( ) j ( rl2 )6, fG -569,o dress of owner(number a d street city state,and ZIP co ) Date of issuance of permit(month,day:year) , i ,3) ()146 i rc�.J-f' r�nc ear �. i� 2 lv S- --�o z Address of location of mobile home( umb ,and street,ci state,and ZIP code) �� Date per expire (ninety(90) rs her date of issuance) 3,2v , t,J 6-)r L -i" / hoe, 5--,3 Make of mobile ho e Yea' I Dimension Vehicle idert:fica:ion numbe• �Sc )G( 147 17 L Y I l "1-') - (ng3 o / - - . Name of purchaser Affected parce num i ccs... i) 3 ...... iv\ Address of purchaser(number and street.city,state,and ZiP code) Is purchaser ov'ng this mobile horn 7 ❑Yes No 1 CERTIFICATION OF COUNTY TREASURER i ne application to move or transfer title(as indicated above)of above described mobile home has been reviewed with the records in this office and I hereby certify that all taxes due on the mobile e have been paid. Signature of County Treasurer Z527401., County Date signed(month.day.year) 6- ,..` bs 0-, DISTRIBUTION: Original-Owner of Mo e Home, Copy-County Treasurer,Copy-County Assessor or Township Assessor. if any