Homestead_Bingham Jr 'vole CLAIM FOR HOMESTEAD PROPERTY TAX ! �� J"S ,'n
:- ' STANDARD/SUPPLEMENTAL DEDUCTION FORM
YEAR
;/ State Form 5473 iR15 r 1-23)
HC10
it'/ Prescribed by the Department o'Local Doverr-=-t=.nance
INSTRUCTIONS See reverse side for filing instructions4
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) 01•IL Y// INriILILr!/ a certify that I(we)occupied as my(our)principal place o /. lAjdOkirMA)
residence or am(are)b y ing the lowing describe•r 6I^pro under contract for which a Homestead Property Tax Standard Deduction is hereby claimed on the Oki
date this a ion is signed. I.C.-Z!-�W (date of signature) I(We) I, I\C/r'`r
❑Am are buying under recoroed contract
❑Am(are)entitled to occupy as attenant-stodthclder of a cooperative housing corporation
❑Have a beneficial interest in the trust or the right to occupy the property under the terms of a gaaldied personal residence trust
0 Am(are)the shareholder,partner,or member of the entity that owns the property
CLAIMANT'S INFORMATION
If Buying on Contract.Fee Simple Owners Name
Recorder's Office Where Contract is Recorded 1 Record Number l Page
PROPERTY DESCRIPTION
County Township -a,ing District rty ltpwn PoQ!Ship j
. .
a b 'L c� it'^,stion
Parcele/ Number Legal Descnph Is the property in question
11 -// 04.23- U eo-+ 703, ga 5^gf( al Property 0 Annually Assessed Mobile Home(IC 6-1 1.7)
I 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 utIded to produce income
, t
r.:11:1)
PROPERTY OWNED ELSEWHERE BY CLAIMANT \\\ M ♦—
State.County.and Township Is Claimant Vacating a Homeste O NI o
1 ❑Yes o r
tV 1..sz Q
Signature of C'a,^•a^t
I hereby certify the above statements are true correct.and complete iN ~
. ,illams)
Addr ss o!:cr+!act inumber and street,a s an i ccde) ddre of//aca!ed Homestead.if any(number and sire a .state and ZIP code iftimmui C� O
Z
ASSESSOR USE ONLY ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL VALUE 0
Land Not Exceeding One(1)Acre Immediately U)
Surrounding Residential Improvement (1) _ i m
U
Other Land (2) :=
Q -0
Total Land(line 1 plus line 2) (3) n
M
1 W GV Q
Residential Improvements or Dwelling (4) O tr
Annually Assessed Mobile I >
Manufactured Home Garage (5) I 00
Other Improvements (6) W GV (,
1 • U
Total Improvements(Line 4 through Line 6) (7) I W L O
Total Value(Line 3 plus Line 7) (8) j
L SD
Signature of Assessor Date Signed(date month year) •0
I hereby certify the above is true,correct,and complete. 1 i
I
Verifying Action-Signature of Auditor 'Date Signed(date month.year) t1
STANDARD DEDUCTION ALLOWANCE
20 Pay 20 Lesser of 60%of the assessed value of the homestead or S48 000
Nofrathstandmg any other provision.the sum of the deductions provided in IC 6-1 1-12 tG a mobile home that
$
is not assessed as real property or to a manufactured home that is not assessed as real property may not
I Q.._
exceed one-hall(1/2)of the assessed value of the mobile horn 77 m/y/a//nuufaacturre`/ed homegnature for __1e�dC��.�.'�J... Date Signed Im nth.day y r1L—_ 1. \\1
OISTRIBUTIO i Original-County Auditor File-Stamped Copy-T axpayer
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