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HomeMy WebLinkAboutHomestead_Lynn (2) Reset Form �!a 4!, CLAIM FOR HOMESTEAD PROPERTY TAX YEAR {4' STANDARD ! SUPPLEMENTAL DEDUCTION FORM \��! State Form 5473(R20/12-24) HC10 I I \_� Prescnbed by the Department of Local Government Finance INSTRUCTIONS See reverse side for Ong instructions NOTE Telephone, Social Security, dnver's license, state identification and federal identification numbers are confidential under IC 6-1 1-12-37 CERTIFICATION STATEMENT I (We) - s rr+tGt.eL.. 11h , certify that I (we)occupied as my (our)pnnopal place of residence or am (are) buying the °lowing descnb real property under contract for a Homestead Property Tax Standard Deduction is hereby claimed on the date application is signed V ' �44 _ (date of signature) I (We) ^TOwn J 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 Recordea Record Number Page PROPERTY DESCRIPTION County Township Taxing District(city.town, township) (1 .1 ‘ ‘D- -N -PfEtr Rce Ac PQ i C\Ce____-\ ( . Parcel Number Legal Description Is the property in question - eat Property El 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 ..i. l 'ID - 1:::) ( Q \ — 00 \ .� (.......... Ij-- C2' . PROPERTY OWNED ELSEWHERE BY CLAIMANT State County and Township Is Claimant Vacating a Homestead ❑ Yes )(No Sign��:,.Qy.t Clarma t Ai I hereby certify the above statements are true,correct. and complete. ' I Address of Contact(number and street. city state. and ZIP code) Address of'aca d Homestead if any(numb and street city state and ZIP code) ASSESSOR USE ONLY ASSESSED VALUE 1 HOMESTEAD VALUE 1 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) Pit Residential Improvements or Dwelling (4) Annually Assessed Mobile/ , . .46-1), Manufactured Home Garage (5) Other Improvements (6) I 24 Total Improvements (Line 4 through Line 6) (7) ©`5- Y Total Value (Line 3 plus Line 7) (8) Giesr■^�'y Signature of Assessor • c°v t;*1(date mon r) - I hereby certify the above is true, correct, and complete. /I0f, Verifying Action-Signature of Auditor Date i . nth year) STANDARD DEDUCTION ALLOWANCE �7 20 Pay 20 _ Lesser of 60%of the assessed value of the homestead or 548 000 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 of Auditor Date Signed(month day year) Lti- VICIN __AN - Pr- \--X'•-`-0j-V.--k-s-A&JO IQ - k--L- ar.:. DISTRIBU ION: Original-County Auditor File-Stamped Copy -Taxpayer Page 1 of 3