Homestead_Barretto Reset Form
✓'- - dr d v CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
(Pi ,' STANDARD / SUPPLEMENTAL DEDUCTION FORM 2
State Form 54731R20 i 12.24) NC10
'- - 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(We) a • Of 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 rs hereby claimed on the
date this application is signed. (date of signature). I (We).
❑ Own. ❑ Am(are)buying under recorded contract
O 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
If Buying on Contract, Fee Simple Owner's Name
Recorder's Office Where Contract is Recorded Hecorc Number Page
PROPERTY DESCRIPTION
County Township Taxing District(city,town. town
�O O�X
Parcel Number Legal Description 1 s th property in question
_ Real Property ❑ Annually Assessed Mobile Home IIC 6-1 1-7) ��
If any portion of the residential structure or the land not exceeding one(1)acre that immediatrly surr that structure is used to produce income.describe the use and portion
of the property utilized to produce income
1
2 () .....- A2 ......_ GI ....._ 10 \ ,000 G .\ ,. ...._ (c) 2..„? .
0
PROPERTY OWNED ELSEWHERE BY CLAIMANT )
State.County,end Township 1 Is Ciai rat Vacating a Homestead"
Yes El No O
Siof la ant ^ �r
I hereby certify the above statements are true, correct, and completeIry yat(J/�V z �- I / 1 -
Address of Contact(number and street ity.sta'e. rind ZIP code) Ad e of Vacated Homestead if any(number and street city te, ZIP code)
53 oc�ks� ' tort __)n- • S$0 tZ 0 - , , Sfi e ) ..1- n-- - -63.
ASSESSOR USE ONLY ASSESSED VALUE I HO',iIESTEAD VALUE I NON-RESIDENTIAL VALUE
Land Not Exceeding One(1)Acre Immediately
Surrounding Residential Improvement (1)
Other Land (2) Pit ,
Total Land (line 1 plus line 2) (3) ' ,:t)
Residential Improvements or Dwelling (4) 1
Annually Assessed Mobile - �l
Manufactured Home Garage (5) V
Other Improvements (6) J////
Total Improvements (Line 4 through Line 6) (7) k 4 2
Total Value (Line 3 plus Line 7) (8) D��+
Signature of Assessor V1es Date Signed(date month year)
I hereby certify the above is true, correct, and complete. QN co,/,�
Verifying Action-Signature cf Auditor N� d(date. month,year)
4U•
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 S
is not assessed as real property or to a manufactured home that rs 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) r
i a 0 �._ -1 - R -',A , 4
pa./
DISTRIBUTION Original-County Auditor. File-Stamped Copy- Taxpayer
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