Homestead_Neufelder (5) %7±"?4
a CLAIM FOR HOMESTEAD PROPERTY TAX YEAR S
,tilt STANDARD I SUPPLEMENTAL DEDUCTION FORM n„�t�
State Form 5473(R19/1-23) HC14 pCU
Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side Willing instructions.
NOTE:Telephone,Social Security,driver's license,stale identification and federal identification numbers are confidential under IC 6-1.1-12-37.
r�",,,,, ! CERTIFICATION STATEMENT
I(We) ' 1 Y £4 / tom(.t�(~FV er, certify that I(we)occupied as my(our)principal place of
residence or am(are)buying the follow?
irig described rrealproner�t r,ander contract for which a Homestead Property Tax Standard Deduction is hereby claimed on the
date this ppiication is signed, 11 [/ (P i�l�late of signature).I(We):
IS-Ur ❑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.
CONTRACT RECORDED
If Buying on Contract.Fee Simple Owner's Name
Recorder's Office Where Contract is Recorded Record Number Page
PROPERTY DESCRIPTION
County f h 5 Township / Taxing Dis is (city,town,to p) 02,
Parcel Number Legal Description Is the property in question:
2619 69--4 OD—bp/ . 2 9g 62 eai Property , ❑Annually Assessed Mobile Home(IC S-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.
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State,4iu-ty,. d ownship I Is Claimant Vacating
ya�Homestead?
�fl�r�}'�- ❑yes t7x1 No
Signal re o Claima ff���"
I hereby certify the above stat•ments are true,correct,and complete.Qj r/� Q
Address of Contact(nu n et,city tate," d ZIP code) I / D Addres Vacated Homest d,d any(number and street.city,state,and ZtP code)
�JF/ / / / `
ASSESSOR USE ONLY ( •1-1:14.94rPI•\t�l telut4-41 1111V_Ult1 ]t?�' ritlfii(�rl:ilkt
Land Not Exceeding One(1)Acre Immediately (t) y
Surrounding Residential Improvement 4i1)
Other Land (2) ,
Total Land(line 1 plus line 2) (3) NO V 1} •
eet-
Annually Residential Improvements or Dwelling (4) (� �d7 ����MAssessedMoblle/ ft Manufactured Home Garage (5)
Other Improvements (6) OI� N COUN y4� �
AI .(
Total improvements(Line 4 through Line 6) (7) R'
Total Value(Line 3 plus Line 7) (8)
Signature of Assessor Date Signed(date,month.year)
I hereby certify the above is true,correct,and complete.
Verifying Action-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 6-1.142 to a mobile home that S
Is not assessed as real property or to a manufactured home th is not assessed as real property may not
exceed one-half(1/2)of the assessed value of the mobile hone or manufactured home.
Signa ur of`Aidit� 0796±/4140* 1 r Date Sigpar�_fh, y,a -./1� `r/ (jjj od O `tt,
DISTRIBUTION:Original-County Auditor,File-Stamped Cop - a layer
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