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Homestead_Bottoms (9)
e�4--,- CLAIM FOR HOMESTEAD PROPERTY TAX �� YEAR (� • STANDARD I SUPPLEMENTAL DEDUCTION FORMI 2-4 Z4 I/� A....,:',, Q _ .�•,, P State Form 5473(R19/1-23) r 1 �yJ C Prescribed by the Department of Local Government Finance U INSTRUCTIONS:See reverse side for filing instructions. NOTE:Telephone,Socia 1: u' r' ' . ' icense,state identification and federal identification numbers are confidential under IC 6-1.1-12-37. 611iVCC CERTIFICATION STATEMENT I(We) , I I{ •Oft\ %\A t r✓ - certify that I(we)occupied as my(our)principal place of 01) residence or am(- = b i..th= N�+�'9�d sy;ibed I property under contract for which a Homestead Property Tax Standard Deduction is hereby claimed on the `�datt�this application is signed, •G L� {�(�� - (date of signature).I(We): ,t]I Own. ❑Alm(are)buying under recorded contract. • (/❑ (are)entitled to occupy as a tenant-stockholder 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. p J El (are)the shareholder,partner,or member of the entity that owns the property. 4 r�--1 CONTRACT RECORDED If Buying on Contract,Fee Simple Owner's Name Recorder's Office Where Contract is Recorded Record Number Page PROPERTY DESCRIPTION County Township Taxing District(city, townsh Son- 00 l w • Parcel Number Legal Description 'Is Ih property in question. Real Property 0 Annualy Assessed Mobile Home(IC 61.1-7) If any portion of the residential structure or the land not exceeding one(1)acre that immediately sun n s that structure is used to produce income,describe the use and portion of the property utilized to produce income. 2-6"'—. 7\ -\ 7-- t u 0-0 oz ' PROPERTY OWNED ELSEWHERE BY CLAIMANT State,County.and Township Is -i•ant Vacating a Homestead? ri Yes ❑No �}/�_�//� Signature of Claimant �' ,7��?�%� ` I hereby certify the above statements are true,correct,and complete. 1 r , • i Address of Contact(number and street,city,state,and ZIP code) Addre o r acated omestead if• 2 �„'r/� any(number and street.city,state,and ZIP code) \I 6 83 9.0 0 .1. \c-- n— .:)1 033 Pth e. , ' v Om 11 -J'�— Li i--4—I Z • ASSESSOR'..SE ONLY ASSESSED VALUE HOME:.TEAD 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) Residential Improvements or Dwelling (4) P/4 Annually Assessed Mobile I Manufactured Home Garage (5) /,/p/��/ Other Improvements (6) "'7Y q -t-Ab Total improvements(Line 4 through Line 6) (7) P Gips ��7 Total Value(Line 3 plus Line 7) (8) N c QJ� Signature of Assessor Oz r " — Date Signe date,mont ear) I hereby certify the above is true,correct,and complete. T 1 Pam, Venfying Action-Signature of Auditor ©ir�pjl�Date Signed(date,month,year) STANDARD DEDUCTION ALLOWANCE 20 Pay 20 Lesser of 60%of the assessed value of the homestead or$48,000. 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. Sign re of Auditor \` Date Minth,ly,year) T,k DISTRIBUTION: Original- ounty Auditor,File-Sta opy-Taxpayer 4. Page 1 of 2