Homestead_Grannan CLAIM FOR HOMESTEAD PROPERTY TAX
STANDARD/SUPPLEMENTAL DEDUCTION FORM YEAR
State Form 5473(R19/1-23) HC70 �OeJ�"I
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) r�✓ rd 1 N � • certify that I(we)occupied as my(our)principal place of
residence or am(are)buying the following described real property under contract for which a Homestead Property Tax Standard Deduction is hereby claimed on the
datelDis application is signed, -r - (date of signature).I(We):
Own. ❑Am(are)buying under recorded contract.
❑Am(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.
❑Am(are)the shareholder,partner,or member of the entity that owns the property.
If Buying on Contract,Fee Simple Owner's Name
Recorder's Office Where Contract is Recorded Record Number Page
PROPERTY DESCRIPTION
Count Township Taxing District(city,town,towns •)O O�
Parcel Number Legal Description Is the prop in quesli.
eel Property ❑Annually Assessed Mobile Home(IC 6-1.1-7)
If any portion of the residential structure or the land not exceeding one(1)acre that immediately surrounds that structure is used to produce income,describe the use and portion
of the property utilized to produce income.
a(0• ao- oa - LAQA - 0o0 . 1-15- OrS
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State,County,and Township Is Claimant Vacating a Homes ad?
❑Yes
Sign CI• int
I hereby certify the above statements are true,correct,and complete.
Address of Contact(number and street,city,state,and ZIP code) Address o a at omestead,i any(num er and street,city,state,and ZIP )
Ot 3 l ^T= . 0 woo -t . O
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) FILE D
Residential Improvements or Dwelling (4)
Annually Assessed Mobile/
Manufactured Home Garage (5)
Other Improvements (6) JUN 21 2024
Total Improvements(Line 4 through Line 6) (7)
Total Value(Line 3 plus Line 7) (8) 4Q,..e try/r,'n,)
Signature of Assessor GrI3SON S'g4J ITOR
I hereby certify the above is true,correct,and complete.
VerifyingAction-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$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.
Signature uditor Date Signed(month,day,year)
a . „..pai- LA1/4_1....27,
DISTRIBUTION:Ongrnal-County Auditor,File-Stamped Copy-Taxpayer \ '�
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