HomeMy WebLinkAboutHomestead_Heseman (2) e.441, CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
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1 ` STANDARD/SUPPLEMENTAL DEDUCTION
2/ State Form 5473(R19/1-23) HC10 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.
CERTIFICATION STATEMENT
I(yye) A t\\,Awn t5e_n•0.n 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, III a da 3 (date of signature) ((We)
Lal'Own ❑Am(are)buying under recorded contract
❑Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation
0 Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified personal residence trust
❑Mi(are)the shareholder,partner,or member of the entity that owns the property
CONTRACT RECORDED
If Buying on Contract,Fee Simple Owner's Name
Recorder's Office Where Contract is Recorded Record Number Page
PROPERTY DESCRIPTION
County Township Taxing District(city,town.township)
C�N o n 0 2 1 M n>1 vtoyne cv,
Parcel Number Legal Description Is the pro in question
24-VI-a o-UOO— I ,S. DOS —0 ` eel Property 0 Annually Assessed Mobile Home(IC 6-1 1-7)
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
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State.County,and Township Is Claimarj1.....4.cating a Homestead,
es Q No
--i.'- .I Signature of ant
I hereby certify ye statemen .r- rue.correct,and complete
Contact(number and street.city state .•• IP code) f s of Vacated Homestead,if any(number and street err,stale and ZIP code) RA an
,`0,L i Al Fc IM1d lei_ 13 S D 6 W 0,-J eA4 v,\k iJJ N 1
V M.S5OR USE ONLY I ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL VALIIF
__-....m..-
Land Not Exceeding One(1)Acre Imm•.1. . 1)
Surrounding Residential Improvement --Other Land (2)
Total Land(line 1 plus line 2) (3) -FI L 1L .
L
Residential Improvements or Dwelling (4)
Annually Assessed Mobile I
Manufactured Home Garage (5)Other Improvements (6) NOV
02
2023 --/
Total Improvements(Line 4 through Line 6) (7)Total Value(Line 3 plus Line 7) (8) Yhir. ""/f
r 1 (gyp
Signature of Assessor GIBSON COlttaxgrMi n4TrrMiR year)
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•o•rle home or manufactured home
Signature of Auditor 1
/ '`4' r' -__ Date Signed(month.day,year) —
DISTRIBUTION: Onginal-County Auditor.File-Stamped Copy-Taxpayer
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