HomeMy WebLinkAboutHomestead_DagesCLAIM FOR HOMESTEAD TAL DEDUCTION
x:F STANDARD !SUPPLEMENTAL DEDUCTION FORM
State Form 5473 (R21 / 7-25) Etl
`ro;+ prescribed by the Department of Local Government France
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
1,
I (we) A certify that 1(we) occupied as my (our) principal place of
residence oram (are) buying the tot bed real property under contract for which a Homestead Property Tax Standard Deduction is hereby claimed on the
IN application is signed, � 0 (date ofsignature). I (We):
5zdate
[]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 trader the terms of a qualified personal residence trust -
[]Am (are) the shareholder, partner, or member of the entity that owns the property.
INFORMATION
Name at Claimant (Iegaf name) Teiepnone Number of Clamar EmaO Address
Klrnbef/ e s (8)9) Lo77-1,-,Z l
-b
Social Security of Clabnant five digits) Driters Licenss / Identilication / Other Number of claim eirt (test dive drgts) Issuing State
(irve able only fi applicant does not have a sodd security number) �?� J
569- &4,5 0
Name of Claimant's Spouse (AI name)
Soda) Sepsity Number of Cletnants Spouse (last five 6gits) D Ws License / Identificaton / Other Number of Claimants Sporree (last rive dgis) IlssuingState
(gppficalik orgy 3applicant's spouse does not have asocial security number)
CONTRACT••i 1
If Buying on Contract, Fee Simple Owners Name
Recorders Office Where Contract is Recorded Record Number Page
PROPERTYDESCRIPTION
County Township Taxing District (pry, town, fownshipI
CI e,�,C-O
Parcel Number
Legal Description Isihep
estion_
-24 - / q — , -.
[ggeaj
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 intone, describe the use and portion
of the property utilized to produce income -
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State Comb T�ship Is Claimant Vacating a Homestead
Yes o
of Eta' nt
I hereby certify the above statements are true, correct, and complete.
1Si
Address of Contact (number and stree city sfete, and ZIP code)
Address of Vacated Horn 'rf y ben street c4, slate, and ZIP code)
7eI"
—
ASSESS DVALUE HOMESTEAD VALUE
NON RESIDENTIAL VALUE
Land Not Exceeding One (1) Acre Immediately (t)
Sisroundin Residential1 merit
Other Land
(2)
Total Land (Line 1 plus Line 2)
(3)
Residential Improvements or
Dwelling
(4)
Annually Assessed Mobile I
Manufactured Home
Garage
(5)
Other Improvements
(6)
Total Improvements (Line 4 through Line 6)
m
Total Value (Line 3 plus Line 7)
(8)
Signature of Assessor
Date Signed (date, mo
1 hereby certify the above is trace, correct, and complete.
Verifying Action —Signature of Auditor Date Signed (date, morith yeaSTANDARD
DEDUCTION ALLOWANCE
For assessment dates after December 31, 2024: in 2025,
$48,000; in 2026, $40.000; in 2027, S30,000; in 2028, S20,0O0;
20 Pay 20
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 horse that is not assessed as real property or to a manufactured home that is not
assessed as real property may not exceed one -halt (12) of the assessed value of the mobile
home or manufactured home.
SianO"Audtor ,
Date Signed (month, day, year)
DISTRIBUTION: Original — County Audio, File -Stamped COPY —Taxpayer
e 'I of 3
IN