Mobile Home_McCullough ,.. AOD Y TA
STANDARDCL IMFOR H/SUMESTEAPPLEMENTALPROPERT DEDUCTION
YEAR FORM !�
State Fonn 5473(R17/1-16) HC10 2-0 t-\
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) itlV ` Il is A M .-rtify that I(we)occupied as my(our)principal
place of resi.ence or am(are)buying the folio,"ng d: •'bed real property under..ntra for which a Homestead Property Tax Standard
Deduction is hereby claimed on the date this appli on is signed, (date of signature). I(We):
❑ Own. ❑ 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.
Recorders office where contract is recorded - ,I I
1
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PROPERTY DESCRIPTION
County O� Township o t Taxing district(city,town,township) 0 20
t. , DECGl� 3
Parcel number Legal description Is the property in question: ,--�
0 Real property ❑A s � e(1C 6-1.1-7)np
If any portion of the residential structure or the land not exceeding one(1)acre that immediately sunotaWs that structure is used _ carpet�l�lfclfeASel as e6A`
of the property utilized to produce income. r� V 4 v
•
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State,County,and Township Is claimant vacating a homestead?
❑ Yes ❑ No
Sign re y
I hereby certifythe above statements are true,corre
ct,and complete.
Address of contact(numberand street,city,state,and ZIP code) ress stated homestead,if any(number and sheet, • ,state,end ZIP code)
321k w ►)4 1tr�►alU r
ASSESSOR USE ONLY • ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL
VALUE
Land not exceeding one(1)acre immediately
surrounding residential improvements (1)
Other land (2)
Total land(line 1 plus line 2) (3)
Residential improvements or Dwelling (4)
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) (8)
I hereby certify the above is true,correct Signature of Assessor Date signed(month,day,year)
and complete.
Verifying action-Signature of Auditor Date signed(month,day,year) �f
STANDARD DEDUCTION ALLOWANCE ` y
20 pay 20 Lesser of 60%of the assessed value of the homestead or$45,000. d/@/ "3
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,•- • ome or manufactured home.
Signature of Auditor s ('� l �t Date signed(month,day, r)
DISTRIBUTION:Original-County Auditor,File-Stamped Copy-Taxpayer
Page 1 of 2 �,
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4R*'a fd.3� s
MANUFACTURED (MOBILE) HOME PERMIT
(a' 1.! State Form 7878(R8/11-17)
. ►`,:/ Prescribed by the Department of Local Government FinanceP4 (( f/(4
s 1 /
Type of mobile home permit I /
-❑Section A-For Moving ❑ Section B-Transferring Title (NOTE: Separate perm! 6‘,c(— S7 OINSTRUCTIONS: •
1. A mobile home may not be moved from one location to another unless the owner obtains a permit to r
2. The Bureau of Motor Vehicles may not transfer the title to a mobile home or change names in any ma
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
judgments,and costs that are due and payable on the mobile home have been paid. The permit shall
permit not later than two(2)business days(excluding weekends and holidays)after the date the treas
4. A mobile home owner who sells the mobile home to another shall provide the purchaser with the perm'
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
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 applyin .er. 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 mobi'e
home(IC 6-1.1-7-3)
7. The requirement to obtain a permit t :de none tnat is c•fferea fo-safe at a:uct , t -t
IC 9-22-1.5. IC 9-22-1.7,or IC 6-1.1
8. Documentation provided by person p ^ I Coji Or;ier -_ BMV Afff;;13;1=O'SeiE .•• =: ,
NOTE: A permit to move or transf Ike the county treasurer issues it.`Wen the permit
expires,it becomes invalid and the '
ATTENTION: MOVER,HAULER, (V� n
A person who is engaged to move (� I �" • presents him with a permit to move the mobile home and
the permit is dated not more than r Dyer shall visibly display the permit while the mobile home
I is in transit.The mover must returr s completed. IC 6-1.1-7-11
r `o•:.ne-'s agent if there is art age, : Agen:'s telephone 1JTcer
I ( ) — —
Na"-e.o'oi.•,ner -- - - - Dare of issuance cf pertiO,�rij:41 j•
•4OJ `,
Address(nu^•mbe,arid street city stare a- Date CerTit eFu res i":"--,( -A ?vs,0_,
* 1 `a=` • o
Make of mobile home yen_'le.dert,fica;�r+yrrt$,lp CO:
Address of present location(numberar- ,..». ,... s.;:_ I __ . A`'e::e7 parcel rt..•b * ,
Address of net;locaton(number and street city,state.and ZIP code) i Cant ` e. . , .-