Homestead_Sweepy '' n:1.'a� CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
as ' . ' Ig, STANDARD J SUPPLEMENTAL DEDUCTION FORM
�/ State Form 5473(R21/7-25) [ HC 10 ..-2,c) 2C P 2:4.
Prescribed by the Department of Local Government Finance .
INSTRUCTIONS:See reverse side for filing instructions. �1J1(1)64% _
NOTE: Telephone, Social Security, driver's license, state identification and federal identification numbers are confidential under IC 6-1.1-12-37. � — �"1•
CERTIFICATION STATEMENT (1's('�//��w/�/\
11 rvl' _ 1� ���
I (We) . 11~� c certify that I(we)occupied as my(our)principal place of ` �i�/�
residence or am(are)buying the f bed reel pcpperty under contract for which a Homestead Property Tax Standard Deduction is hereby claimed on the U
•at= I is application is signed. 1 _ �(� (date of signature). I (We): 1
Pill Own (are)buying under recorded contract. 'Q
•Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation. ' C�3 •
Have a beneficial interest in the trust or the nght to occupy the property under the terms of a qualified personal residence trust.
ElAm(are)the shareholder, partner,or member of the entity that owns the property
If Buying on Contract, Fee Simple Owner's Name
Recorders Office Where Contract is Recorded Record Number Page
PROPERTY DESCRIPTION
County Township Taxi 1(city.town,township)
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Parcel Nun Legal Description property in question
Real Property Ej 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 surroun tha tructure is used to produce income,describe the use and portion
of the property utilized to produc come
2_____ '-- \--2;--- 0(7,--- \u - cpo1 . '‘, S — c) 2._-8\
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State County Township Is Clai acatiny a Homestead?
Yes ❑No
Sigy�fur of Claimant
I hereby certify the above statements are true, corre
ct,and complete.X
v
Address qt,Contrumber and sheet city state.and ZIP code) of Vacated H estead,rYf�n (nu rand st I.city, state, and ZIP code)
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ASSESSOR USE ONLY ASSESSED VALUE HOMEcfEAD VALUE NON RESIDENTIAL VALUE
Land Not Exceeding One(1)Acre Immediately ):..
Surrounding Residential ImprovementOther Land ( ILE ...
Total Land (Line 1 plus Line 2)
y
Residential Improvements or Dwelling (4)
Annually Assessed Mobile 1 J A N 0 7 2020
Manufactured Home Garage (5)
t 1
Other Improvements (6)
Total Improvements(Una 4 through Una 6) l
Total Value (Line 3 plus Una 7) 6laSON COUNTY AUDITOR
Signature of assessor Date Signed(date. month.year)
I hereby certify the above is true,correct.and complete.
Verifying Action-Signature of Auditor Date Signed (date. month. year)
STANDARD DEDUCTION ALLOWANCE
For assessment dates after December 31. 2024: in 2025.
20 Pay 20 S48.000. in 2026, 540,000;in 2027, $30,000; in 2028 520.000.
in 2029,S10,000;and beginning with the 2030 assessment date
and for each assessment date thereafter. SO s
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_( /2)of the assessed value of the mobile
home or manufactured home \,
Signature of Auditor (rici '
^� Date Signed reeve,' ri .year) 2 7-•\I Y--) -fil
at
DISTRIBUTION: Original-County Auditor File-Stamped Copy-Taxpayer
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