Homestead_Cravens (2) d�^ ti" CLAIM FOR HOMESTEAD PROPERTY TAX YEAR_
�d• y STANDARD/SUPPLEMENTAL DEDUCTION FORM ,�_
'. , State Form 5473(RId/1-23)
HC10 �T`�
•'• Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for filing instructions.
NOTE:Telephone.Social Secunty,driver's license,state identification and federal identification numbers are confidential under IC 6-1.1-12-37.
CERTIFICATION STATEMENT
MgI(We) try certify that I(we)occupied as my(our)principal place of
residence or a l are)buying the following described real property under contract for which a Homestead Property Tax Standard Deduction is hereby claimed on the
daattee}his application is signed,__ -__Lt.`____3,_(date of signature).I(We):
5el 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.
❑Arn(are)the shareholder,panner;or member of the entity that owns the property.
CONTRACT RECORDED
It Buying on Contract_Fee Simple Owner's Name
Recorder's Office Where Contract is Recorded Record Number Page
PROPERTY DESCRIPTION
County 1 Township Taxing District(city.town,township)
l" ( hS f� fDcv rio in rf vn r G; sC 0
Parcel Number) ) el;t , Legal Description Is the openy in question
(eQ-0OO*)k l ��I W p1I� {-3-1 `r 1,v0 4-C- Real Property ❑Annually Assess (IC6-1.1.7)
ll Lon oc(ylia�perJ��ki'dentia st}9,� or the land not exceeding one(1)acre that immedia@Iv nds that structure is used to produce inc a(E�+vsc a the a and portion
of kiperTy HWzed'10 prodict+wcae. (! }\ t) - \_,C(C- -11
13XAT
rZ0'3
PROPERTY OWNED ELSEWHERE BY CLAIMANT 7�State.County.and Township Is Claimant Vacatingt om:s 7• y'"a
Sig :ore of Claimant , ~Yes ts'\V Ago
I hereby certify the above statements are true,correct,and complete. /J,� SQ\J
" G\6
1.11
Address of Contact(number and street.city.state.and ZIP code) Add ss of V sated Homestead,it any(number and street.city.state,and ZIP code) n�
ASSESSOR USE ONLY ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL VALUE land Not Exceeding One(1)Acre Immediately \j,.‘..\:.'11111\\i"
Surrounding Residential Improvement (1)
Other Land (2)
Total Land(line 1 plus line 2) (3) lf`\
Residential Improvements or Dwelling (4) \
Annually Assessed Mobile/ J
Manufactured Home Garage (5) l
Other Improvements (6) '
Total Improvements(Line 4 through Line 6) (7)
Total Value(Line 3 plus Line 7) (8)
Signature of Assessor Date Signed(date,month.year)
I hereby certify the above is true,correct,and complete.
Verifying Action-Signature of Auditor Dale Signed(date.month,year)
STANDARD DEDUCTION ALLOWANCE /A'7-
20 -Pay 20 Lesser of fi0%of the assessed value of the homestead or 548,000. O\' r
Notwithstanding any other provision,the sum of the deductions provided in IC 6-1.1-12 to a mobile home that $ A`�
is not assessed as real property or to a manufactured home that is riot assessed as real property may not /`
exceed one-half(t/2)of the assessed value of the mobile home or manufactured home.
Signature of Auditor Date Signed(month.day,year)
it • —1 "2-40 12- .
DBUTI N: Original-County Auditor,File-Stamped CopyTaxpayerv�--'u`lamJ...... 9
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