Homestead_Weymouth (2) 'p
a1 CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
�► • STANDARD / SUPPLEMENTAL DEDUCTION FORM
\• f., ;,;ate FOfm 5473(R21 /7-25) HC10 _ O Al
•'• Prescribed by the Department of Local Government Finance c l _
INSTRUCTIONS: See reverse side for Cling instructions O�' {� ( , A
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NOTE: Telephone. Social Security, driver's license, state identification and federal identification numbers are under IC 6-1.1-12-37.
CERTIFICATION STATEMENT
I (We) QL 1, V (NC\QLx_i-k\ certify that I(we)occupied as my(our)principal place of
reside or am(kre tw in the f Ilowin described r-..I • 'lay under contract for witch Homestead Properly Tax Standard Deduction is hereby claimed on the
date Ut' application is signed, - -A- _ _ (date of signature) I M
�i•rn ❑Am (are)buying under recorded contract.
❑Am (are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation.
ElHave 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 Recorded Record Number Page
PROPERTY DESCRIPTION
County Township Ta ' District(city, town, township) n
Q .) ,u,....„..„,,,,,.......„.4_k.0-k\c) ca,-->. . .
Parcel Number Legal Description Is the pr party in question
1 eel Property ❑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 incomec3iL t ,/�
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PROPERTY OWNED ELSEWHERE BY CLAIMANT
State County Township Is Claimant Vacating a Homestea)Y'
❑Yes RNo
Signs a of Claimant
I hereby certify the above statements are true,correct, and complete. a cii.L2 1 •: fr
Address of Contact(number and street. city. state,and ZiP code) Address of Vacated Homestead.if any(numbs d street,city.state, and ZIP code)
60t t� • �— le ate. i •
ASSESSOR USE ONLY ASSESSED VALUE HOMESTEAD VALUE NON RESIDENTIAL VALUE
Land Not Exceeding One(1)Acre Immediately (1)
Surrounding Residential Improvement
Other Land (2) F LED
Total Land (Line 1 plus Line 2) (3)
Residential Improvements or Dwelling (4)
Annually Assessed Mobile i
Manufactured Home Garage (5) DEC 12 2025
Other Improvements (6) r
Total Improvements(Line 4 through Line 6) (7) , !
Total Value Pile 3 plus Line (the.r eu a. .4it#6 )
O GIgSnN.rnut\ITY AUDITOR
Signature of Assessor Date Signed (date. month,year)
I hereby certify the above is true, correct, and complete.
Ventying Action-Signature of Auditor Date Signet (date. month. year)
STANDARD DEDUCTION ALLOWANCE
For assessment dates after December 31.2024: in 2025,
20 Pay 20 S48,000, in 2026, $40,000. in 2027.$30,000: in 2028.$20 000.
in 2029, $10,000: and beginning with the 2030 assessment date
and for each assessment date thereafter,$0.
$
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
+Sig ire of �r - Date Signed (month. y, year
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DISTRIBUT N: Original-County Auditor. Foe-Stamped Copy-Taxpayer -- �r-� ,
lt �,lti ‘1(' Ala_ l' t "�' 2_, — ' L Page` o` ` c s J`_A` ` \ i - Vms0.1 . .., )rr)�.1:- •ate ci- k S�e_r . 1 v '