Homestead_Wigand ""��° CLAIM FOR HOMESTEAD PROPERTY TAX - )
1i1 ) FORM YEAR
STANDARD/SUPPLEMENTAL DEDUCTION I 2
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‘, ..7 State Form 5473(R19/1-23) 0
or•/ Prescribed by the Department of Local Government Fnarcr
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(We) 'a , fat, A A iSSo-S t!Akin certify that I(we)occupred as my(our)principal place of
residence or am(are)buyinri the following described real propender contract for which a Homestead Property Tax Standard Deduction is hereby claimed on the
date�.�,/this application is signed. 'a/is/o93 (date of signature) I(Wei
LSD�'n, ❑Am fare!buying under recorded contract
Am(are)entitled to occupy as atenant-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 entty that owns the property
CLAIMANT'S INFORMATION
Recorder's Office Where Contract is Recorded 'Record Number Page
PROPERTY DESCRIPTION
,County ^ • Township "axing District/city r_._ ' - _
Parcel Number Legal Descnption l Is the property in question
a6_lq_3\_3%3— coo 030 001 Property 0 Annually Assessed Mobile Home(lC 6-11-7)
If any portion of the residential structure or the land not exceeding one(1)acre that e,,,c,ed ate),surrounds that structure is used to produce income describe the use and portion
of the property ut Lzed to produce income
I
i
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State.County.and Township _ an;yacating�a Homestead/
i / e ?'to es o l
i I hereby certify the above statements are true.correct,and complete -/Un./IY/w
iiiaIrd—
Address of Contact(number and street.city state and ZiP cede) -cdress of acated Homestead if any(number and street ty state and ZIP code; i
613 Vine 4- A s._. - - 4 . - 119 1 cace.. Poe- r 5e c —^/ 5141
ASSESSOR USE ONLY ASSESSED VALUE I HOMESTEAD VALUE I NON-RESIDENTIAL VALUE
Land Not Exceeding One(1)Acre Immediately (1)
Surrounding Residential Improvement FI
Other Land (2)
. E D
. .._
Total Land(line 1 plus line 2) (3)
Residential Improvements or Dwelling (4)
Annually Assessed Mobile I - DEC 2 20��
Manufactured Home Garage (5)
Other Improvements (6) i - -
1 1 �i-
i Total Improvements(Line 4 through Line 6) 1(7) I G1e$ON C `�►'
Total Value(Line 3 plus Line 7) I(8) I I ' AUDIT"
` 1 a
Signature of Assessor I Date Signed(date month.year) I
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 assesses.; .• .- or S48 Oa:
Notwithstanding any other provision.the sum of the deductions prov'ded in IC 6-1 1-12 to a mobile home that S
is not assessed as real property or to a manufactured home!hat•s not assessed as real property may rot
exceed one-half(1/2)of the assessed value of the mobil h or manufactured home 7I
Signature of Auditor ‘ReDate Sig (month. a ail I
DISTRIBUTION: Original-County Auditor File-Stampe ',payer
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