Homestead_Richardson .$72, CLAIM FOR HOMESTEAD PROPERTY TAX YEAR,
%to:1, STANDARD/SUPPLEMENTAL DEDUCTION FORM
State Form 5473(R19/1-23) HD10 (96
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 I(We), 't '"-. P ,.... 1 alarrir
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
ate is application is signed, (date of signature),I(We):
Own. El Am(are)buying under recorded contract.
0 Am(are)entitled to occupy as a tenant-stockholder of a cooperative
(
Recorder's Office Where Contract is Recorded
Record Number Page
PROPERTY DESCRIPTION
cafe Town orttrole:A_ Tae DistriglThvottio.wris
Parcel Number Legal Description Is the property in question:
Real Property 0 Annually Accesed 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.
6 ,/q, 01_ Lioti,_zo 0
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State,County,and Tow'ship Is Claimant Vacating a Homestead?
/1 El Yes Xislo
Signature lairnt
I hereby certify the above statements are true,correct,and complete.
'vd. k_.
Address of Contact(number an.st'el,city state,and ZIP code) s 'Idress of acated omestead,if any(num rend stmet,city,state,and ZIP code)
4001
3oa. e i 4--PLc51- 61 ,
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)
Residential Improvements or Dwelling (4)
Annually Assessed Mobile I
,',- .. •
Manufactured Home Garage (5)
Other Improvements (6) ,,-, . :111.Ar 0.0', 025111(4
,
1
Total Improvements(Line 4 through Line 6) (7)
Total Value(Line 3 plus Line 7) (8)
G;3 C:14-e-eg,-,i„. (52
Signature of Assessor --,....ffy CO . -,4* to Signed(date,month,year)
I hereby certify the above is true,correct,and complete. ''uNrY. -4424t.)
Verifying Action-Signature of Auditor 1!•.fit,(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 anufactur me that is not assessed as real property may not
exce d ortezhalf(1/2)of the assesse value of h MO lie home or manufactured home.
Sign ur f Auditor tzklitx:0 Datifigned 7M,2?Ye )1426,4,s____
S.....
DISTRI UTION:Original-County Auditor,File-Stamped Copy-'Taxpayer
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