Homestead_Kramer (17) /' ,x''a CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
STANDARD I SUPPLEMENTAL DEDUCTION HC10 7-�L3
`i/ State Form 5473(R19/1-23)
._ 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.
,,,gyp CERTIFICATION STATEMENT
I(We) WV" ♦NA"l` ___ certify that I(we)occupied as my(our)principal place of
residence or am(ar . ying the folloy+i d rbe operty under contract for which a Homestead Property Tax Standard Deduction is hereby claimed on the
dat is application is signed. d rya (dale 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
If Buying on Contract.Fee Simple Owner's Name
Recorders Office Wnere Contract is Recorded Record Number Page
PROPERTY DESCRIPTION
County q3c)
- Township 1 Tazing District(city,town,townshi -•
Parcel Numb Legal Description I I t property in question
Real Property ❑Annually Assessed Mobie Home(IC 6-1 1-7)
If any portion of the residential structure or the land not exceeding one(1)acre that immediately sun and that structure is used to produce income.describe the use and portion
of the property utilized to produce income
..2...... C-.--- t•R ..--\.S _ lio 2.....J0 0 0
, (33 .3----° -oa .
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State,County,and Township Is Claimant Va ting a H stead',
. _ _ ❑Yes No
Signature o mart
lete
I hereby certify the above statements are true,correct,an. om
P ®INII. i_
Address of Contact(number and street city state and ZIP c..e) / ..yad s o R cared IT'ste if ny(nurpbe,and street�city,state.an. IP code)111 _
2 eh1--- S - 0 n 6 4 S
ASSESSOR USE ONLY I ASSESSED VALUE HOMESTEAD VALUE I NON-f ESIDENTIAL VALUE
Land Not Exceeding One(1)Acre Immediately i )
Surrounding Residential Improvement
Other Land (2)
Total Land(line 1 plus line 2) (3)
Residential Improvements or Dwelling (4) �. .FILED
Annually Assessed Mobile
Manufactured Home Garage (5)
_ - --Other Improvements (6) OCT 05 2023
Total Improvements(Line 4 through Line 6) (7)
Total Value(Line 3 plus Line 7) (8) Ykauz J a 1/YaL4 ncj)
Signature of Assessor Date Signedi6af8&OMvENDUNTY AUDITOR
I hereby certify the above is true,correct,and complete.
Verifying Action-Signature of Auditor Date Signed(date month.year)
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 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 h nufactured home
Signature of Auditor N Datt$rgae ( nth. 4y-year)
DISTRIBUTION: Original-County Auditor.File-Stamped Copy-Taxp yer
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