Homestead_Halbig (2) Reset Form
a`'$lT4►� CLAIM FOR HOMESTEAD PROPERTY TAX
ii't STANDARD 1 SUPPLEMENTAL DEDUCTION FORM YEAR
HC10 �—
Stale Form 5473(R20 1 12-24) Z )
_Nail-- Prescribed by the Department of Local Government F.ra-ce
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/ M. ��I C •
certify that I (we)occupied as my(our)principal place of
residence or am(are),iying the fallowing described rea property un ontract for which a Homestead Property Tax Standard Deduction is hereby claimed on the
date,3his application is signed. (date of signature). I(We)
On. Am (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 nght 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
County Township -• Taxing Distract(city, town. township)
IC)
io,...2
Parcel Number Legal Description Is the operty in question.
eal Property ❑ Arvwaty 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 sumo that structure is used to produce income,describe the use and portion
of the properly utilized In produce income
, ,-----. ...... (i.) 2 _____ .
(2_6/- ...... 1 -2 _ 0,,s,-...._ Lioa...._ 0. uc . 7()
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State.County.and Township
Is Claimant Vacating a Homestead?
!Yes ❑ No
Signature of Claimant
I hereby certify the above statements are true, correct, and complete. (hss '
feWly_ Ariu.:40 y':..4,
Address of Contact(number and street, city stale. and ZIP code) Addressl of V ed Homestead.if any(number and street,ci s' and ZIP code)
• 0 IV -- 9 SS 1 l - ,► -_ ") - l 6 f'1c S1. r- •)-
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) F ILE ij
i
Residential Improvements or Dwelling (4)
Annually Assessed Mobile/ --
Manufactured Home I Garage (5)
SEP 23 2025
Other improvements (6)
Total Improvements (Line 4 through Line 6) (7) 7 J ��
Total Value(Line 3 plus Line 7) (8) A:awl aj .iYfirie '� ."",,�}
Ti'f AUDIT DR
Signature of Assessor �1BSON t�UV ry 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
2i= Pay 20 Lesser or 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 S
is not assessed as real property or to a manufactured home that is not assessed as real property may not
exceed one-half(tit)of the assessed value of the home or manufactured home
Signature o` r Date S nail Own: , day, year!
DISTRIBUTION• Onginal-County Auditor File-Slam:�i .y -Taxpaye-
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