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HomeMy WebLinkAboutMobile Home_Monroe (2) (7* CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR STANDARD ! SUPPLEMENTAL DEDUCTION fff •, -.i State Form 5473(R19 i 1-23) HC10025 Prescnbed 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 11 I (We) certify that I (we)occupied as my(our)principal place of residence or . . (are)buying the foll. • c •-s�r}b re I r rty under contract for which a Homestead Property Tax Standard Deduction is hereby claimed on the date this application is signed, � �/� (date of signature). I (We): p Own. ❑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 If Buying on Contract.Fee Simple Owner's Name r Recorder's Office Where Contract is Recorded Record Number Page c\- \ PROPERTY DESCRIPTION Count Township / .� ^ (� Taxfhg Ds 'L,town • shi. l#50ti • U 0 ......C.2_5211-"-- Parcel Nombe• L escript.on Is the property in question c).e.A...v.)511 0 Real Property Annually Assessed Mobile Home(IC 6-1.1-7) II 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 income. D s� Y267- PROPERTY OWNED ELSEWHERE BY CLAIMANT State,County,and Township Is Claimant Vacat g a Homestead? ❑ Yes No Signatur t Claimant I hereby certify the above statements are true, correct, and complete. 1 C _, ICI Address of a number and scree ty tate, an 1 code) Address Vacated Homestead,if any(number and street,city, state, and ZIP code) ` • L CA- '�. gel �,AI In1 1 \vn ASSESSOR USE ONLY I ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL VALUEcc\ Land Not Exceeding One(1)Acre Immediately (1) Nv Surrounding Residential Improvement Other Land (2) r Total Land (tine f plus line 2) (3) '1 :44 Residential Improvements or Dwelling (4) 4611) Annually Assessed Mobile/ -. A/o Manufactured Home Garage (5) �� Other Improvements (6) 1 ens V� Total Improvements (Line 4 through Line 6) (7) �i/e �l,I r %Sbills VI Total Value (Line 3 plus Line 7) (8) CO/,C? Signature of Assessor Date Sig `� ear) I hereby certify the above is true, correct, and complete. 44 Verifying Action-Signature of Auditor Date Signed (date, mon • th, STANDARD DEDUCTION ALLOWANCE 20 Pay 20 Lesser of 60 of the assessed value of the homestead or$48,000. 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 property or to a manufact :• home that is not assessed as real property may not exceed one hat(1/2)of the asse 4 value oft e mobile home or manufactured home. / Signat e •I Audi or / VAlito Date ign ( rh, d e `� (....--\./ alp DISTRIBUTION: Onginal-County Auditor File-Stamped Copy-Taxpay Page 1 of 2 \sccct5).) r