HomeMy WebLinkAboutHomestead_McClellanCLAIM FOR HOMESTEAD PROPERTY TAX
i STANDARD / SUPPLEMENTAL DEDUCTION
1 State Form 5473 (R21 17-25)
'•'-� Prescribed by the Department of Local Government Finance
FORM YEAR
HC10
INSTRUCTIONS. See reverse side for riling instructions.
NOTE: Telephone, Social Security, drtvers license, state identification and federal identification numbers are confidential under IC 6-1.1-12-37,
I (We) i en Q c f �l - C'f r C LC No c CERTIFICATION certify that I (we) occupied as my (our) principal place of
residence or a (Are)tbiuying the fall des t�td_,.rea^l p}°perty under contract for which a Homestead Property Tax Standard Deduction is hereby claimed on the
�nCi
this application is signed, Q L� JOC l D (date of signature). I (We):
,d�ate/
LyJ Own. ❑Am (are) buying under recorded contract.
❑ARI (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 cast
❑ Am (are) the shareholder, partner, or member of the entity that owns the property.
INFORMATION
Name of Claimant (legal name)
Telephone Number of Claimant Email Address
c 81bv UU14- 361-10
Social "ty Numbercf Claimant past five tligits)
river's Uceri I Identification I Other Number of Claimant (last a tlg@s)
(Applicable only if applicant does not have a social security number)
Issuing State
Name of Claimant's Spouse gegal name)
Social Security Number of Claimant's Spouse (last five digits) ers License I Identification I Other Number of Ciamants Spouse (last five cWs) Issuing State
(Applicable only if applicant's spouse does not have a social security number)
CONTRACT•'■ ■
If Buying on Contract. Fee Simple Owners Name
Recorders Office Where Contract is Recorded Record Number Page
PROPERTY
County
Township
Taxing District (city. town, township)
Parcel Number
Legal Description Is
the propertyin question:
Real
Q 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 properly utilized to produce income.
PROPERTY
State County
Township Is Claimant Vacating a Homeste 7
El Yes No
5ignatVu FB rmant
I hereby certify the above statements are We, correct, and complete.
el
x/ � s
Address of Contact (number and street, city, slate. and ZIP code)Address of V "rf orrMead. any (number and street city, state, and ZIP code)
, fc ` p
ASSESSORONLY ■ VALUE HOMESTEAD• •
Land Not Exceading One (1) Acre Immediately (1)
Surrounding Residential Improvement
Other Land
(2)
Total Land (Line 1 plus Line 2)
(3)
Residential Improvements or
Dwelling
(4)
Annually Assessed Mobile I
P.
Manufactured Home
Garage
(5)
Other Improvements
(6)
Total Improvements (Line 4 through Line 6)
U
(7)
SON
Total Value (Line 3 plus Line 7)
(8)
N
Al —
Signature of Assessor
to Signed (date. month, year)
1 hereby certify the above is true, correct, and complete.
Verifying Action - Signature of Auditor
STANDARD DEDUCTION ALL
Date Signed (date, month. year)
For assessment dates after December 31, 2024: in 2025,
$48.000; in 2026, $40,000: in 2027. $30,000; in 2028, $20,000;
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 home that is not assessed as real property or to a manufactured home that is not
assessed as teal property may not exceed one-half (1/2) of the assessed value of the mobile
home or manufactured home.
signature of Auditor
Date Signed (month. day. year)
n1
L 1 C)
DISTRIBUTION: Onginal — County Auditor, File -Stamped Copy — Taxpayer
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