Homestead_Newton . _ Reset Form
,:_ CLAIM FOR HOMESTEAD PROPERTY TAX
sue_ YEAR
i► STANDARD / SUPPLEMENTAL DEDUCTION FORM 2,�
,.• / State Form 5473(R20/12-24)
HC10
�'�� Prescribed by the Department of Local Government Finance
INSTRUCTIONS See reverse side for filing instructions
NOTE Telephone, Social Secunty, driver's license, state identification and federal identification numbers are confidential under IC 6-1 1-12-37.
CERTIFICATION STATEMENT
7
I ('Ne) a M I S • certify that I (we)occupied as my(our) pnnapal place of
residence or am (are) .uying 1 f• •i r•• d I property under contract for which a Homestead Property Tax Standard Deduction is hereby claimed on the
Oil LA this application is signed, (date of signature) I (We)
�J V� n m(are)buying under recorded contract
❑ Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation
1,, ❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified personal residence trust
�--LL y `� ❑ Am(are)the shareholder. partner, or member of the entity that owns the property
\ 1V -
.
CONTRACT RECORDED
If Buying on Contract.Fee Simple Owners Name
Recorder's Office Where Contract is Recorded Record Number Page
PROPERTY DESCRIPTION
County Townshig.........N _ 'axing District(City town,towC
u)2.,
Parcel Nu tier Legal Des n 1 property in question
Real Property Li 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 su un that structure is used to produce income,describe the use and portion
of the properly utilized to produce income
"...3-• (:) ......... a"- 2 - \ 2S0000 t ,. cA-4,.....1 ,...... 024
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State.County, and Township Is Claimant Vacating a Homestead"
_, Yes Ill No
Signature of Claimant
I hereby certify the above statements are true. correct, and complete. ...__Vtiat. .47. Z--Xid--/--------- #("14*- -----`'
Address of Contact(number and street. city. state, and AP code) Address of Vacated Homestead, if any(number and street, city, state and ZIP code)
\\Vi S 1 - ni-13. 3'
ASSESSOR USE ONLY ASSESSED VALUE I 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) ilF I jED
Annually Assessed Mobile/
Manufactured Home Garage (5)
Other Improvements (6) ocr
Improvements (Line 4 through Line 6) (7) (j`-IJ U 2025
Total Value(Line 3 plus Line 7) (8)
Signature of Assessor to Signed (date. month year)
I hereby certify the above is true, correct, and complete. GIBS CO/1, I ,
Verifying Action-Signature of Auditor �I v �OUNTY " ate month year)
,Q
V(J!
OR
STANDARD DEDUCTION ALLOWANCE
20 Pay 20 Lesser of 60%of the assessed value of the homestead or S48 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 Sign onth ay year)
01W —G, thr,.S S CO i�
DISTRIBUTION. Original-County Auditor. File-Stamped Copy-Taxpayer
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