Mobile Home_Sparks "'x'�\ CLAIM FOR HOMESTEAD PROPERTY TAX I tv?�" �� FORM -- YEAR ll STANDARD I SUPPLEMENTAL DEDUCTION G�� I d f� HC10 1 IN '+` %� State Farm 5473(R79/1-23) `+'r% 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-i2-37, �r7 CERTIFICATION STATEMENT • C. ��✓ r certify that I(we)occupied as my:our)principal place of I residence or am(are; rig the Poll wing described real property under contract for which a Homestead Property Tax Standard Deduction is hereby claimed on the 1 date this application is sgried. (date of signature) I(We! I )?9 Ov:n 0 Ain!are+buying under recorded contract I I0 Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation 4 0 Have a beneficial interest in the trust or the right to occupy the property under the terms of a q_ialified personal residence trust 0 Ash(are)the shareholder,partner,or member of the entity that owns the property CONTRACT RECORDED I if Buying on Contract.Fee Simple Owner's Name I (Recorder's ON,ce'Ahere Contract is Recorded I Record Number I Page I - • I I PROPERTY DESCRIPTION County C p�/n Township (''�j !Taxing Didtiict lorry town 1 ivc,b Q t + J 11' 1 © L� t�'S I Parcel Number J Legal Description :s the property m question 1 I I 0 Rea:Property Annually Assessed;Jot-tie Home(IC 6-1 1-71 1 I If any cannon of the rev-dentist structure or the land not exceeding one(11 acre that.rnmed.ate°y surrounds that structure's used r pro be income.describe the use and portion 1. i at the property utilized to produce income I 3 _ _ato-Lir-i-05t.plAa-co ) • I. PROPERTY OWNED ELSEWHERE BY CLAIMANT State.County,and Township Is Claimant Vacat g Homestead' 1 \ ` ❑Yes No ' Sc� ..ire y^� ; I hereby certify the above statements are true correct.and complete ,,,,,- I Address of C^n,eu n- .ber and 5 rty s and Zthc e. - AdI"�r� d if any:number and street crry.state and ZIP coon ASSESSOR USE)ONLY I ASSESSED VALUE I HOMESTEAD VALUE NON-RESIDENTIAL VALUE I LandurrNot ExceedingReside One )Acre Immediately (1) V }y ! Surrounding Residential Improvement o/y`,1,,`+� I �i , I Other Land 112i CCC i + Total Land(line 1 plus line 2) 1(3) S 1 I Residentialnally Improvementsor Dwelling (4) *4161) Annually Assessed Mobile t — 1 Manufactured Home 1 Garage 1(Si '; _ }-Other Improvements I(6) - 1 1'0 cVe I I �J 1 Total improvements(Line 4 through Line N I(7) Y Cb C ) I Total Value(Line 3 plus Line 7) I(8) I I �Ik; �� Signature of Assessor !Date Signed(date month OrT II hereby certify the above is true,correct,and complete. '0 'Verifying Action-Signature of Auditor Date Signed,+date month yearn I STANDARD DEDUCTION ALLOWANCE 20 Pay 20 Lesser of 60%5 of the assessed value of the homestead or SAS 000 -'thstandmg any other provision.the sum cf the deductions provide _,i ,t 1-t2 rc a mobile nome that S assessed as real property or to a manufactured home that-s nor ease•-ed a real properly.may not I"trx;.r,:-ed one-half(112)of the assessed value f ymobrte home or mnm.°cur red awe I ` ( -.—_— Date Signed lmonrh yay _art - ±'"� 2-ut ` -........ ‘..7.‘ 1 Signature or Auditor L _ -I/�/--�=/\- ♦Ay� DSSTR)BLITION: Ongral-County Auditor =de-Starrcec Copt-Taxpay • Page 1 of 2 / t/ • (11.7. k ° MANUFACTURED (MOBILE) HOME PERMIT , o- +;rc•• i State Form 7878(R9/3-20) f 4g I 11 _ y;;,�„� Prescribed by the Department of Local Government Finance „ w o mobile home permit: �( [ ction A-For Moving IQ Section B-Transferring Title (NOTE: Separate permits required if owner intends to both move and transfer title.) INSTRUCTIONS: �l 1. A mobile home may not be moved from one location to another unless the owner obtains a permit to move the mobile home from the county treasurer. 2. The Bureau of Motor Vehicles may not transfer the title to a mobile home or change names in any manner on the title to a mobile home unless the owner obtains a permit to transfer the title from the county treasurer.(IC 6-1.1-7-10) 3. A county treasurer shall issue a permit which is required to either move,or transfer the title to a mobile home if the taxes,special assessments,interest,penalties, judgments,and costs that are due and payable on the mobile home have been paid. The permit shall state the date it is issued. The treasurer must issue the permit not later than two(2)business days(excluding weekends and I holidays)after the date the treasurer receives a completed permit application. (IC 6-1.1-7-10) 4. A mobile home owner who sells the mobile home to another shall provide the purchaser with the permit required before the sale is consummated. This obligation does not apply to a mobile home offered for sale at an auction under IC 9-22-1.5 or IC 9-22-1.7.(IC 6-1.1-7-10.4) A person who violates this commits a Class C infraction.(iC 6-1.1-7-14) 5. A mobile home owner must present a copy of this permit to the Bureau of Motor Vehicles when applying for title transfer. If the mobile home is to be moved;a separate permit must be requested prior to moving. 6. A Form 1(Notice of Placing of Mobile Home Upon Land or Lot)must be filed with the assessor within thirty(30)days after the date of placement of the mobile home(IC 6-1.1-7-3) 7. The requirement to obtain a permit to move or transfer title to a mobile home does not apply to a mobile home that is offered for sale at auction under IC 9-22-1.5,iC 9-22-1.7,or IC 6-1.1-23.5 for the transfer resulting from the auction.(IC 6-1.1-7-10(a)) 6. Documentation provided by person requesting this permit(IC 6-1.1-7-10(d)) ❑ State issued Title ❑ Court Order ❑ BMVAffidavit of Sale or Disposal NOTE: A permit to move or transfer title to a mobile home expires ninety(90)days after the date the county treasurer issues it.When the permit expires,it becomes invalid and the owner must obtain a new permit. ATTENTION: MOVER,HAULER,OR TOWER A person who is engaged to move a mobile home may not provide that service unless the owner presents him with a permit to move the mobile home and the permit is dated not more than ninety(90)days before the date of the proposed move.The mover shall visibly display the permit while the mobile home is in transit.The mover must return the permit to the owner of the mobile home when the move is completed.IC 6-1.1-7-11 Name of owner's agent.if there is an agent acting on the owner's behalf Agent's telephone number SECTION A-MOVING PERMIT ( ) _ 7v--may:of owner Date of issuance of permit(month,day year) i O .,.. AddOss( rr r�8r.and'street,city,state,and ZIP code) Date permit expires(ninety(90)days after issuance) ,Make of mobile Nat) .,,, Year Dimension Vehicle identification number "AdidEsArer t focAlicln(num`berand street,city,state.and ZIP code) Affected parcel number . ,