Mobile Home_Collins (5) ''`•' ••CLAIM FOR HOMESTEAD PROPERTY TAX
FORM YEAR
`//// STANDARD I SUPPLEMENTAL DEDUCTION HC10
d ,, . State Form 5473(R I9/1-23)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for filing instructions.
NOTEi.Telephone,Social Security,driver's license,state identification and federal identification numbers are confidential under/C 6-1.1-12-37
CERTIFICATION STATEMENT
I(We) of i C \t1$ 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, (We).
'ova 3 (date of signature).I
I"!"O.--wn ❑Am(are)buying under recorded contract.
❑Am(are)entitled to occupy as a tenant-stodcholder 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
I
If Buying on Contract,Fee Simple Owner's Name p °.
Recorder's Office VMere Contract is Recorded Record Number Page
PROPERTY DESCRIPTION
County Township Taxing Di Mct(pity,town,fu}�hip)
GI►tean � -
, � ice;uQC.
Parcel Number Legal Description Is the property in question-
0 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 surrounds that structure is used to produce income,describe the use and portion
of the property utilized to produce income24 ..— L 1 ---/ ___ 0 3 0 z.„1 --- 00 ,
g.
\
PROPERTY OWNED ELSEWHERE BY CLAIMANT /�
State,County,and Township Is Claimant Vacating a Homestead?
�,L'{..111
e El No 1
Signature of Clai t `
I hereby certify the above statements are true,correct,and complete
Address of Contact(number and street,city,state,and ZIP code) Address of Vacated Homestead,4 any(number and lstree,a ,state.and ZIP code) )O
(551/<" yIC!1 'cAr;_.— , , , Iy6 r bec,ci e IA Ie;-D., 7 yx 1 a 1/4-8ASSESSOR USE ONLY ASSESSED VALUE I HOMESTEAD VALUE NON-RESIDENTIAL VALUE
Land Not Exceeding One(1)Acre Immediately (1) �V
Surrounding Residential Improvement Other Land (2)
Total Land(line 1 plus line 2) (3) F E D
Residential Improvements or Dwelling (4)
Annually Assessed Mobile IManufactured Home Garage (5)
Other Improvements (6)
Nov 0 9 2023
Total Improvements(Line 4 through Line 6) (7) L /� 17
+
Total Value(Line 3 plus Line 7) (6) jBSONN CCCOUNTY],/`A�UDITOR
Signature of Assessor Date Signed(date,month.y
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 548,000.
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 home or manufactured home.
•
jkms....,Signatur A ilor 4/0 c, / Data Signed(month,day.year)
,.._..,c1;.? .1
DISTRIBUTION: Original-County Auditor.File-Stamped Copy-Taxpayer —1
Page 1 of 2 '
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R.•1F
:,'%- MANUFACTURED (MOBILE) HOME PERMIT
( o17 OPY
a" State Form 7878(R9'3-20)
;yam ;,! Prescribed by the Department of Local Government Finar c: ,
Type of mobile home permit: —1
El Section A-For Moving Section B -Transferring Title (NOTE: Separate permits required if owner intends to both move and transfer title)1
INSTRUCTIONS.
1. A mobile home may not be moved from one location to another unless the owner obtains a permit to move the mobile home from the county treasurer.
2. The Bureau of Motor Vehicles may not transfer the title to a mobile home or change names in any manner on the title to a mobile home unless the owner obtains a
permit to transfer the title from the county treasurer.(IC 6-1.1-7-10)
3. A county treasurer shall issue a permit which is required to either move,or transfer the title to a mobile home if the taxes,special assessments,interest,penalties.
judgments,and costs that are due and payable on the mobile home have been paid. The permit shall state the date it is issued. The treasurer must issue the
permit not later than two(2)business days(excluding weekends and holidays)after the date the treasurer receives a completed permit application.(IC 6-1.1-7-10)
4. A mobile home owner who sells the mobile home to another shall provide the purchaser with the permit required before the sale is consummated. This obligation
does not apply to a mobile home offered for sale at an auction under IC 9-22-1.5 or IC 9-22-1.7. (IC 6-1.1-7-10.4) A person who violates this commits a Class C
infraction.(IC 6-1.1-7-14)
5. A mobile home owner must present a copy of this permit to the Bureau of Motor Vehicles when applying for title transfer. If the mobile home is to be moved,a
separate permit must be requested prior to moving.
6. A Form 1(Notice of Placing of Mobile Home Upon Land or Lot)must be filed with the assessor within thirty(30)days after the date of placement of the mobile
home(IC 6-1.1-7-3)
7. The requirement to obtain a permit to move or transfer title to a mobile home does not apply to a mobile home that is offered for sale at auction under
/C 9-22-1.5,IC 9-22-1.7,or IC 6-1.1-23.5 for the transfer resulting from the auction.(iC 6-1.1-7-10(a))
8. Documentation provided by person requesting this permit(IC 6-1.1-7-10(d)) ❑ State Issued Title ❑ Court Order ❑ BMVAffidavit of Sale or Disposal
NOTE: A permit to move or transfer title to a mobile home expires ninety(90)days after the date the county treasurer issues it.When the permit
expires,it becomes invalid and the owner must obtain a new permit.
ATTENTION: MOVER,HAULER,OR TOWER 1
A person who is engaged to move a mobile home may not provide that service unless the owner presents him with a permit to move the mobile home and
the permit is dated not more than ninety(90)days before the date of the proposed move.The mover shall visibly display the permit while the mobile home
is in transit.The mover must return the permit to the owner of the mobile home when the move is completed.IC 6-1.1-7-11
--1Name of owner's agent,if there is an agent acting on the owner's behalf Agent's telephone number
)
SECTION A-MOVING PERMIT
Name of owner Date of issuance of permit(month,day.year)
Address(number and street,city state and ZIP code) Date permit expires(ninety(90)days after issuance)
Make of mobile home Year Dimension Vehicle identification number
Address of present location(number and street,city state,and ZIP code) Affected parcel number
Address of new location"number and street,city,state.and ZiP code) Contact telephone number
( )