Homestead_Richardson "`� CLAIM FOR HOMESTEAD PROPERTY TAX .
t � YEAR
�' STANDARD! SUPPLEMENTAL DEDUCTION FORM i i(�2
x' - _ HC10
,.' ate._ - 3.3'; _--_
F-essnted o,the Cesar-rent D.Lr-a ._.e.' ._rt c a :.
INSTRUCTIONS See reverse side for filing,nstruchons
NOTE Telephone,Social Security,drivers license state identification and federal ioentr6cation numbers are confidential under IC 6-1 1-12-37.
CERTIFI;ATION STATEMENT
i We' �'riraU ' '/ el WAW7W ISO") -- _-cert!y trial I Ine'occuped as my'our pnncipa place of
reede a O'a^(are:b�yT !,_fo xhad�s- t pr`Fe y - 3 .,. : 1 C eslea:Praper!,Tax Staroaro Ded._r cn ;hereby c aTed or Inc
dal sappscat:cr:ssgeed Ill ) V�+L-I -
0w^ ❑Ar. a'e o..yng -, _- -== t'a:'.
m.late,entitled to occupy as a tenant-stocxhcder of a cccre-a:.=-e_s'c c.2'c_'a'_-
❑Have a bereficia,:merest in the trust or the',ght to occupy t' : - --- -'a 3-a =e's:-a ---,_._.,_ ;
D Am(are;the shareholder,partner,or membe-of the e-'::.'' _ _-_ ___
•'f Buy:rg or,Contract Fee S.mpie Done•s e • • 1
Reco-dens Ott.ce.tre•e Contract s Reco'Ce- - -•' --- _
R
PROPERTY DESCRIPTION
Court:y Tdv oo •
--
�o • Milif_
-i.-,, •.,-der l.e,a-:«- :- .. _[-^y s;cr
;se-t, ❑Ar',_aly Assessed:':.r._-re'C�'1 '
, e resde^La'struoN.'e or the!a-d-a:e._ are a_re: .,• .. -c:re,s. __..re s..sed to roduce r.corre describe tie_se and port c-
P2......_.6 ..-- \13 ---7 ..)_______ .---- 0 0 Ooo 03 � oo "-6 .
PROPERTY OWNED ELSEWHERE BY CLAIMANT
•State County.and Township ___--a-:`/aca!, r -.•estaadn •
❑yes , rwl
I hereby certify the above statements are true corre tand compie:e .�w-7i f...,, Zee:..
d-_ss
ff--.. ..._., ,. . _•-,r and s;ree'are s!a!e arc Ze code
ASSESSOR USE ONLY I ASS,=SSED VALUE HOMESTEAD VALUE I NON-RESIDENTIAL VALUE
Land Not Exceeding One(1)Acre Immediately
Surrounding Residential Improvement
Other Land 12
Total Land(line 1 plus line 2) ;3,
- ---7
Residential Improvements or Dwelling i,4;
. Annually Assessed Mobile l - _-- -
Manufactured Home Garage ':5,
Other Improvements i(6;
Total Improvements(Line 4 through Line 6) ,71
Total Value(Line 3 plus Line 7) g i
Sr_ra:.;-e: Assess. Ode S;net(date rhomr yea-
-
I hereby certify the above is true,correct,and complete.
Vert fy-rg Action-S g•a^i•e a'Lao Die S.gred date meet- fed,'
STANDARD DEDUCTION ALLOWANCE
22 Pay 22 Lesser of 9:' of the assesses. • -• -
•
Not.:,thstanding any otner prorois,cn me Sam cf;re dedoc!'crs_--:. _ _ - - - `
,s not assessed as real propert/Sr to a manufactured home ,- -- - _a_ - -
e.ceed one-half t 1,2)of the assessed va.' f the moo.fe hcn e - -!..re ^c._=
S,gnature of AAdo, 11-10-2_kl'.
.._.___ 'A,) Li
DISTRIBUTION Cr g,rai-::.^!i a_d,.c• _.e-5ca"-sea:op.- a.cayer t
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