Homestead_Cain °1 CLAIM FOR HOMESTEAD PROPERTY TAX I YEAR
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STANDARD / SUPPLEMENTAL DEDUCTION FORM ac
\ r/ State F uini 5473(R21 /7-25)
HC10
Prescribed by the Department of Local Government Finance l
INSTRUCTIONS. See reverse side for filing instructions.
NOTE. Telephone, Social Security, driver's license, state identification and federal identification numbers am confidential under IC 6-1.1-12-37.
I CERTIFICATION STATEMENT
te
I(We) JP ♦ - ! Ai certify that I(we)occupied as my(our)principal place of
residence or am(are)buying the f '.:.j rider contract for which a Homestead Propertyapplicationsigned. Tax Standard Deduction is hereby claimed on the
ppl i9 (date of signature) I (We)
7/
.,xOwn. ❑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
Recorders Office Where Contract is Recorded Record Number Page
4PROPERTY DESCRIPTION
Cov -t ) G 0 QAJ T.
. ► l Taxi .has'. r to m,township)f - C
' /71! r
Pare Number Legal Description Is the property in question
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.descnbe the use and portion
of the property utilized to produce income
C2k-Or. - -/ g- ---6.1 -- 20S r 60 a -/7,10g.
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PROPERTY OWNED ELSEWHERE BY CLAIMANT
State i C ,/�i, T. .i't. Is Claimant Vacating a Homestead? Q
'� I I f �. t��/ 'Gl1 /) 9 , 'fen Yes ❑No
Signet o Claim t 1
I hereby certify the above statements are true,correct. and complete.
�, .
Addr•: of Gar r,^ .^�� . rrnnr s tt,and Zlpyode) Address pt Vacar�H este�ad.i1404/C/7----/
beue ,uty, state, and ZIP code) �[c- c . 'c.. 2• "I'-J' 61 t!G' C� tom /U ' % CMG ci7)'1 �T j ,4/q
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ASSESSOR USE ONLY ASSESSED VALUE HOMESTEAD VALUE NON RESIDENTIAL VALUE 0
Land Not Exceeding One(1)Acre Immediately (1) C)
Surrounding Residential Improvement ,
Other Land (2)
O
Total Land (Line 1 plus Line 2) (3) 0
0
Residential Improvements or Dwelling (4)
da
Annually Assessed Mobile/ -
Manufactured Home Garage (5)
Other Improvements (6) /') ---
EC 9
Total Improvements (Line 4 through Line 6) (7) 4 ? 20 r • CI)
, �i
Total Value (Line 3 plus Line 7) (8)
Signature of Assessor G/ S (date..month,year)
I hereby certify the above is true, correct, and complete. 8SO
o�,
Verifying Action-Signature of Auditor Date SfgririA(fie
A
STANDARD DEDUCTION ALLOWANCE
For assessment dates after December 31.2024: in 2025.
20 Pay 20 $48.000. 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/C 6-1 1-12 to a
mobile home that is not assessed as al property or to a manufactured home that is not
assessed as real property may n xceed one-pall(1/2)of the assessed value of the mobile
h or nufactured home / c\N\)C\s's
+Sig of /Latt ,,,0 1 i I � /i Date Signed( plat �
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DISTRIBUTION: Onginal-County Auditor. File-Stamped Copy-Ta pay
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