Homestead_Muncy 1"-A�'a\ CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
\ STANDARD/SUPPLEMENTAL DEDUCTION FORM
� '/1 State Form 5473(R1911-23)
r� 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(We) ' { certify that I(we)occupied as my(our)principal place of
residence or am( 11buying the ft le iertporty under contract for which a Homestead Property Tax Standard Deduction is hereby claimed on the
da this application is signed, ( I (date of signature) I(We)
Own ❑ (are)buying under recorded contract
(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation
El Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified personal residence trust
❑No(are)the shareholder,partner,or member of the entity that owns the property
last five digits) Issuing State
�
Social Security Number of Claimant's Spouse(last five digits) I Drivers License/Identification/Other Number of Claimants Spouse(last five dgds) Issuing State
(Applicable only if apo/cant5 spouse does rot have a social secunty number)
CONTRACT RECORDED
If Buying on Contract,Fee Simple Owner's Name c
Recorder's Office Where Contract is Recorded Record Number Page r
J
3.1
PROPERTY DESCRIPTION O
County /\ Township o 0 ,Taxing District try �town.tow 1 i;
41
Parcel N mb r Legal Description Is property in question y _
Real Property t-10.A C._.
CIAnnually Assessed Mobile Home(IC 6-1 1-7) 1 v
If any portion of the residential structure or the land not exceeding one(1)acre that immediately suit nd that structure is used to produce income.describe the use and portion
of the property utilized to produce income
2.--6 .-- - 1 -o0O , g-3 Z -72oz� .
\S ) 0000uf
`
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State.County,and Township Is Claimant Va ting omestead7
l ❑yes AEI No
Signawre of Claiman '
I hereby certify the above statements are true,correct,and complete
Address of ContaOct(number apd reel.a state ag&21P code) —
D� Address of Vacated Homestead.ifany(number and street a state.and ZIP code)
ASSESSOR USE ONLY ASSESSED VALUE HOMESTEAD VALUE ' NON-RESIDENTIAL VALUE
Land Not Exceeding One(1)Acre Immediately (1)
Surrounding Residential Improvement
Other Land (2)
Total Land(line 1 plus line 2) (3) I M O
war or
Residential Improvements or Dwelling (4)
Annually Assessed Mobile/
Manufactured Home Garage (5) F.B 0 1 2024
Other Improvements (6) I
Total Improvements(Line 4 through Line 6) (7) GIBBON CO � �,�)
Total Value(Line 3 plus Line 7) (8) t UNTY gUOI /('��"���
Signature of Assessor Date Signed(date TaWn.year)
I hereby certify the above is true,correct,and complete.
Venfying Acton-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 S
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 ho anufactured home
Signature of Auditor • I - )r as Date Sign (r9pdth, year)
OV/\-\)2 (.1
DISTRIBUTION: Ongmal-County Auditor.File-Stamped Copy-Taxpay r
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