Mobile Home_Taborn .,��o. CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
a fi. s STANDARD(R78 FORM
HC1O
/SUPPLEMENTAL DEDUCTION Loaa
i Stale Form 5473
\,irk-e 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
1� STATEMENT
I(We) `-a_ \.A 4-u5 (•t u._.vr r\ 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, 1 — OoZ pl. (date of signature). I(We):
n. ❑ 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.
CLAIMANT'S INFORMATION
(Applicable only d applicant's spouse does not have a social security number)
CONTRACT RECORDED 411
If buying on contract.Fee Simple owner's name 4 A'
'Ires-
Recorder's office where contract is recorded Cite, er Pa
° ZZ
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PROPERTY DESCRIPTION _
County Township 10 Taxing district(city town.township) ,qth,
do
Parcel number Legal description .Is the property in question.
0 Real property malty assessed mobile home(IC 8-1.1.7)
-It 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 properly utilized to produce income 01&_ /d e—o s«S O - oc7
PROPERTY OWNED ELSEWHERE BY CLAIMANT
Stat County.and own.hip — _Is claimant vacapt
'MY es
A'� Si.I re of aimant
I hereby certify the above statements are true,correct,and complete.
Me - ..Al Ilk: R- .�
Address of contact(number and street,city state.and ZIP code) ••ddress of vacated homestead.if any(number and street,city,state.and ZIP code)
0�.�3 If ) • rncv jc. ` Lo . AI . cP(O8 .3• Si • P/ .,
ASSESSOR USE ONLY ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL
VALUE
Land not exceeding one(1)acre immediately F T
surrounding residential improvements (1) .. ". `r•>0,
(� • Other land (2) --- `,4"1
01
Total land(line 1 plus line 2) (3)
V Residential improvements or Dwelling (4)
amanufactured
asured mobile/ w
l,�\V\,.J manufactured home Garage (5)
r Other improvements (6) s•c,a},'' ty-3,i, ,; d r`:
Total Improvements(line 4 through line 6) (7)
�'�r 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)
STANDARD DEDUCTION ALLOWANCE
20 pay 20 Lesser of 605i 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)
V46_,Ir\a—i_ Q a N.,' ,OLAT3.: 3 rY\a,ei_D
DISTRIB ION: Original-County Auditor,File-Stamped Copy-Taxpayer
Pa e 1 of 2
-&- MANUFACTURED (MOBILE) HOME PERMIT
itifi = -- - -,. --- :-- --;
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Section A-For I,lo. ^ng Section B -Transferring Title (NOTE Separate pe'rnirS req_:ired if pi.,ner irterlds to both move and transfer title
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 treasure-
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 obtar s a
permit to transfer the title from the county treasure- (IC 6-1.1-7-10)
shall issue a permit whichis required eithereor transferthe to a mobile if ,r) taxes.special assessments.interest.penalties.
3 A county treasurer s a.. r q to move. title p a home the
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)ate-the date the treasurer r eceives a completed permit application. (iC 5-1.1-7-10;
4 A.mobile home or, ._ i.ho Sells the mobile hbn'.e to another shall provide the purchaser with the e-rn;r qu'rG beforethe
,n"'` Se p_ .ray_.. d b�p. sale is consummated This obligation
does not apply to a mobile home offered for sale at a- ...t on 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 mast present a cols" _ - _ ,7)-3-,' _ . e Bureau of Motor Veb'cres when apoiy.'rg for true transfer. the ahome tobe mo
ved.Ifmob,l., is a
separate permit must be requested prior to
6 A Form I(Notce of Placing of Mobile Han:= U::: .t a- .,'Lot:must be fired with the assessor v;ithin th;r i i(.30 days after the date of lof the
t- ! ,. pia:.,me-t ^:oo•e
home(lC 6-1.1-7-3
requirement ob• n rr' ;,c - - b'!=homedoes apply to a mob me fnatt is of°ered fo-sate at a..ctaon u^.-_
7. Th., equl e.-^ .. a ape c-.r;�- - - - _ ,� � _noti<1•;, _
IC 9-22-1 5 /C p 22-1 7 or IC 6 1-2?5 forthe t a ug from the auction iIC 6-1 1 7 17tai;
t. e'; 5-1 1-7-l0l State Issued Titre Order — o' or Disposal
�. DOC',!'� ... _ _ .:rdec by Ae o_,c� _-� ,.y p � �/- � _ Court Ord. B t/Air:cia,.t Sale
: NOTE: A.ce to move or transfer title to a mobile home expires ninety(901 days after the dare the county treasurer issues it.When the permit
expires. be:oroes invalid and the owner must obtain a ne,v permit.
ATTENTION: MOVER,HAULER,OR TOWER •
Aver son who is engaged to more a mobile home may not provide that se^lice tin''�'.s S ohs re. e._. S huff^with a permit to move the mobile home and
t is dated not more than ninety(90)days before the date of the propose: _. - _ = visibly display the permit while the mobile home
-. ._ The -"'h r-..st re.tim the pe-mil to the ovine of Inc mobile home „ _ . t'e rro re is co p'eted. IC 6-1.1-7-11
_-. = s a- e ,'S ti-c ---- A t s telepro e.rut,__. .
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SECTION A-MOVING PERMIT
_—_-- _ _ --____ --_- • Date a`issua-:e r'perm':(mrl:nth dal yea')
. t >:•.e-. �_ - ^iffy sa.- :Z. Dare F.rT''t e ,'-r=i 1-..t/(l J.days 8-=-;53.3,":;,:'
e _ ) e -- - Yea- D-oer.s> - - ;el-.Cle ide ,,:Cat pr r,u.,.ber
---- -
, _C 3 :"- _5S- .- . . _ `J s' - :- e . -a` Z, co_e. ------ --- _step parcel rJmbe- ---------
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