HomeMy WebLinkAboutHomestead_Horrall I Reset Form 1
,�`� ''�� CLAIM FOR HOMESTEAD PROPERTY TAX nbs,Y_EAR
( tto i STANDARD / SUPPLEMENTAL DEDUCTION FORM O
\6 i State Form 5473(R20 1 12-24) HC10 _
\� _-%• Prescnbed by the Department of Local Government Finance LJt
INSTRUCTIONS See reverse side for hhng instructions
NOTE Telephone. Social Secunty dnvers license. state identification and federal identification numbers are confidential under IC 6-1 1-12-37
CERTIFICATION STATEMENT
I (We) - lin• / e& , 0 r r CU certify that I (we)occupied as my (our) pnnapal 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
date the application is signed 11. 110 "'a5 (dale of signature) I (We)
b/wn Am(are)buying under recorded contrail
Am (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 Owners Name
Recorders Office Where Contract is Recorded Record Number Page
PROPERTY DESCRIPTION
Coun Township ' /� Taxing District(city, town wnship)
\ILC 4::. -4a-k---,1/4-N--.1---V-A,--e'
Parcel Number Legal Description Is the prope y in question
cal Property ❑ Annually Assessed Motile Home(IC 61 1-7)
If any portion of the residential structure or the land not exceeding one ill acre that immediately surrounds that structure is used to produce income describe the use and portion
of the property utilized to produce income
ir:91\....Q . 0 ... ---- t 0 0 "e* nLL- i . ''?- 4F LA , clocc),
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State County and Township Is Claimant Vacating
,aHomestead?
`-- Yes L.y'No
Signal r Clai an s -
I hereby certify the above statements are true.correct. and complete i/ttJLt ,.a4 '
0 _401-
Address of Contact(number and street city state`, and ZIP co e) Address of Vacated Homestead if any(number and street city state and ZIP code)
e t i 4v\ie 1. ,.
ASSESSOR USE ONLY ASSESSED VALUE 1 HOMESTEAD VALUE NON-RESIDENTIAL VALUE
Land Not Exceeding One(1)Acre Immediately j1)
Surrounding Residential Improvement
Other Land (2)
Total Land (line 1 plus line 2) (3) FIL -_ -
Residential Improvements or Dwelling (4)
Annually Assessed Mobile I
Manufactured Home Garage (5) NO V 1
Other Improvements (6) >,2z......
2025
Total Improvements (Line 4 through Line 6) (7)
Total Value(Line 3 plus Line 7) (8) GiBSON - rr`1,1►A�,•. .�
r.k, gr)14("0
Signature of Assessor OvrV OreA00O nth year)
I hereby certify the above is true, correct, and complete. R
Verifying Action-Signature of Auditor Date Signed (date month year)
STANDARD DEDUCTION ALLOWANCE
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 properly 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)
( O_i ,
DISTRIBUTI N: Original -County Auditor. File-Stamped Copy -Taxpayer •
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