Homestead_Forkel-Matte :.A+ Reset Forma
tr CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
' STANDARD)SUPPLEMENTAL DEDUCTION FORM
Swats cia 5473(Rig r,-n.3 HC10
P o merited by the Department d Local Orwrrmere Finance
INSTRUCTIONS.See ramie aids for Hang instructions
NOTE:Telephone,Social Scrawny,ddve/s/icwua,afar rdererrwtlon end f.dra!0oretficaticn numbers are conIdanHN and IC 8-1.1-12 37.
CFPTIFIf EIlnU STATEMENT
I M/e)F04114aab,Harts ElLiBee ION Mello certify that I(we)occupied r top(our)primal place of
terror Of an tare)buying the frolpg dencrird real under contract for which a Homestead Property Tao Standard Deddbn ill herebyrn hereby daed on the
dale the appioation la alpnad, y r ' f4,Z 4 y (W Y d s/unahMD)I(we).
23044n. ❑Am(era)buying undo;recorded contract
❑Am(m)*,retied to comp/as•terraMatookhoNet of a cooperaN•housing corporation.
❑Have a brrs4W ironer in[Mho*or the right to occupy Its prop.rty under Its lama of a molted personal'renders Mr
❑Am(m)the sherandder,partner,or norm of the entity Owl ovate the pmparty
If Buying on Contract.Fee 91mph Curses Neme
__._.. -- Record Number Page
Reorders Cfbe Wnere Contract a Reoorsied
PROPERTY DESCRIPTION
County Towi Wp T ax.rrp Der,n(oty roan,lovemnp)
Gaon ( t{o54n JOhnson 024
Parcel Humor Legs Carnation U the property In cordon
Q Rea Property ❑Manly Aeaarad mod.Bane)CfFl.1-7)
If any Peen of its leackf tial structure or the*0 rot mom/hp One(1)axe tat immediately arround that efrodure R used to product.macro*,descrbe era ne and Dalian
of are piopeop utmed to produce dune.
26-18-33-100-002.819-024
PROPERTY OWNED ELSEWHERE BY CLAIMANT
and Twaalfa 1.Claimant Vacating a Hmre.MeQ'r
Elide.Count!, ■Yes r❑Pb I
i nmw c«w Ow.bow aTeaarirta an true,corral,and complete. �( ,_ ,
peypa or coma(number era drat city,slats and ZIP code) Aram drooled Honeebed.rt any(number mb red arne(oly stare ar.1 LP.tat,
9890 S 450 W,Cynthiana,IN 47612
AL'.trrSSSC&USE n-a r ASSESSED VALUE_ I HOMESTEAD VALUE 1 NON-RESIDENTIAL VALUE
-.Nei @Iro�e4rTQ_W 111 Awe IrnmedfdY (1)
.r O..r Lain ww+� R) ---4
Teti Land Mae 1 plus ar.7) (3) -_.-1
paaid.ntut impfovMwr1 or Dwelling (4)
Moony Amour MOWN I
e radectuad Hare Oraoe (5)
-
•
parr Ir0PrverrNrea (8) -I
Tout urpovemres(Ur 4 through Line e) m
Tato Valve NrN!lotus Una 7) (8)
I harry trey bra abeve is bud,done,and conrplre. ave.
d pare •
awned(are.main,
Vnenre Ada,-fopr.er d humor
Cot.4pnad(date mien.year)
STANOANO DEDUCTION ALLUnV4NCt \'�
L"raa'd dOtr to Ili sa.a.s,p talus d 1ib ran,wo,d rr fIs,O3D, '
20
Anci asyo:::ronrM,dAesund Medenim:aa•aaald as a.a'Fyopsr7y u b a meru/ec0Yed 7Nrtp 1I tt0f 0 h IC ad ant 1d a ns.D61 hon.
That
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eaasddae-yya.yf�d due suresraJ vasty ON aretN Olaf N nd asmaasd as reef PrbPrfY ma •
�f
*moa craw• ��� taBd •D(ms. y
pip G�6e _ 7
CISTIIMUTkat crow 'amoae minim,
2"1 Shnaf(maN!`day, CO
may ' (��,`'
Pigs 1of2 47//1
9