Homestead_Hobson CLAIM FOR HOMESTEAD PROPERTY TAX f YEAR
� l 1' STANDARD/SUPPLEMENTAL DEDUCTION FORM (� �� /� -
s, ;/ State Form 5473 0319 r 1-23i HC10 , �// ) • t I
F-esrnbed oy the Cenartrre-t o'L^_a c.e _e �ttiCr`'�,{I"''
INSTRUCTIONS See reverse side for filing instructons
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' , -ft♦ r., A' .So.�1 1J.rr-- _�Q- Js-•r __cert`,tn,a'I':.e.ccc..c•ed as my'our.pnncipa1 place of
res.derce or a tare.buy,rg'-e'3 :es:-cea rea 2'-- , ::.,--a-,' - .. ' _ c o;eaa P'cce^(y Tax Sta-cara Ded..cr On s herety c'a,''ed on the
date
th s appiica.icn s s gned 3-U- Z0Z 14 ;-E_of sgna,e
p Am(are,ant:t ed tO OCCupy as a tenant-stoarnc de-e`__= c_s-g c___a_
❑Ha.e a se'efca Interest in the trust cr tre',gn:to cc._ -. . :cc'. _ __ . e. 5. :- _._a're,.e-s,-a 'es cc-re'-_s.
❑Am tare;the shareholder partner or men-Le 1 .-__ --_ _,e'cy
CLAIMANTS INFORMATION
-._ ^tract Fee Simple C✓•ne•s Name
Reoomer5 Off.ce A'nere Contracts Recorded I Rec^.•o',_-ter 'a;e
PROPERTY DESCRIPTION
ce.i...,.1lo Pr►' _ Q -A- -0 -.DDo-°Oa Gar-°o .
1 _--'J!_ dFecy ❑?1--.,.al,Ass., :, 1.1 . . ..
--- o
('any con on ct the res.dentia stn:ct-re or the a-o-.ct e _--g_ e)1';s: ,. ...a:-a,st act.re s used to croduce ncome d sc c,. '-
o'tne procerty ut zed to p'ed,.oe•ccome
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State County and Township .Weteado
---1 'gym c r true correct and coin fete --- -� �— �� �
hereby certify the above s.a.., e is are p 4 ,
Aod-ess= .arac,.r,.-o_ 3-ifs __ _,-, _•a'e ='d: >_._s.:. .3:wed :-. -- —r .ar;,.y.. ZPc.--
ASSESSOR USE ONLY ASSESSED VALUE I HOMESTEAD VALUE I NON-RESIDENTIAL VALUE
Land Not Exceeding One(1)Acre Immediately I(1)
Surrounding Residential Improvement -
Other Land (2.
T
Total Land(line 1 plus line 2) i 3; 1/_r/ T
L
Residential Improvements or . Dwelling ,i4! E
Annually Assessed Mobile I -
Manufactured Home ' Garage '.5; MA A p 202
' Other Improvements I(6, fT A 4
Total Improvements(Line 4 through Line 6) 17 t/
Total Value(Line 3 plus Line 7) !(8) N COUN Y i'¢
t
46,
5•gnatre c'Lsse<, :re Signed Nate •--- Au0iT
I hereby certify the above is true.correct,and complete. OR
Verfyrg action-_g-at_-_. 7a'e Signed date _ ,e_
STANDARD DEDUCTION ALLOWANCE
2L Pa,2: __ Loose';•' e assesse':• - ••
hotc=tnstand,ng any otner cr,. . _• - ..__ _ . .__ _ _ -
d not assessed as real proper/ar tc _ .•_ _--• , .=r assessed as._- , -, . -
I erceed one-haf 1."2,,of the assessec.___ _ - __ _ _ __•manufactured^cme
S,gnature cf Aud,to•
DISTRIBUTI N -. ._
g'ra!- . , _ xc-.e S'a—ced:op+--aarer '
Page 1 of 2
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so,,,,,iv MANUFACTU`'...1 4: PERMIT ,State Form 7676(ROINAtE
nse
6, d !-`.cv
Type of mobile home permit
❑Section A- For Moving -_ Section B -Transferring Title (NOTE: Separate permits required if owner intends to both move and transfer title.)
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
IC 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 %j Court Order LI1 BMV Affidavit 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
Lexpires,it becomes invalid and the owner must obtain a new permit.
i ATTENTION: MOVER,HAULER,OR TOWER k
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
Name of owner s agent if there is an agent acting on the owners behalf 1 Agent's telephone number
i ( )