Homestead_Braselton (2) di-j °a� CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
i �1 STANDARD/SUPPLEMENTAL DEDUCTION FORM e.2
i/ State Form 5473(R19/1-23) HCf 0 YEAR
J Prescribed bythe Department of Local Government Finance
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INSTRUCTIONS:See reverse side for filing instructions.
NOTE Telephone,Social Security,driver's license,state identification and federal identification tubers are confidential under IC 6-1.1-12-37.
I(We) 1r certify that I(we)occupied as my(our)principal place of
residence or am(are)buying the following described real property u contr a Homestead Property Tax Standard Deduction is hereby claimed on the
At is application is signed, (d e of signature) (We)
n El Am(are)buying under recorded contract
❑ (are)entitled to occupy as a tenant-stodiholder 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 S'mple Owner's Name
Recorders Office Where Contract is Recorded Reccrs'.ember 'Rage
PROPERTY DESCRIPTION
County l/Township O ,Taxing District(city town.township)^ 140
01\
Parcel Number 1 Legal Descripson tin r perty in question `-11•'v-'
VV Real Property ❑Annually Assessed Mobile Hume(IC 6-1 t-7)
If any portion of the residential structure or the land not exceeding one(1)acre that immediately sum nit that structure is used to produce income,describe the use and portion
of the property utilized to produce income
e/2........_6 -,--\ 2___ ____ C 6 .....: 0"-1 _00 . L2)41 ___02„:53.... _
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State,County,and Township Is Claimant Vacati''omesteadn
0 Yes r1 No
1 Si nature of lei t
I hereby certify the above statements are true.correct,and complete 1 Y• /6'S •
Address of Contact(number and str-et ty state an 1,•de) s of V c Homestead if any(number and street city,state and ZIP code)
ASSESSOR USE ONLY ASSESSED VALUE HOMESTEAD VALUE ', NON-RESIDENTIAL VALUE
Land Not Exceeding One(1)Acre Imm=•ately (1) lIl
Surrounding Residential Improvement
Other Land (2) \\*)
Total Land(line 1 plus line 2) (3)
V .
Residential Improvements or Dwelling (4) 1Q�3
Annually Assessed Mobile/
Manufactured Home Garage (5) w\Ov
Other Improvements (6) C� �( �
Total Improvements(Line 4 through Line 6) (7) ( (.ti' v��PV��
Total Value(Line 3 plus Line 7) (8) u N O��j�
Signature of Assessor G"''' Date Signed(date.month year)
I hereby certify the above is true,correct,and complete.
Verifying Acbon-Signature of Auditor I Date Signed(date month,year)
STANDARD DEDUCTION ALLOWANCE
20 Pay 20 Lesser of 60%of the assessed value of the homestead or S48,000
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 h - not assessed as real property may not
exceed one-half(1/2)of the assessed value of the mo /I ho a or anufactured home
Signature of Auditor \ Dite Sig etl�n y. ear��// •
________a_
DISTRIBUTION: Onginal-County Auditor.File-Stamped y-Tax er
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