HomeMy WebLinkAboutHomestead_White (2)CLAIM FOR HOMESTEAD PROPERTY TAX v1 AR
STANDARD / SUPPLEMENTAL DEDUCTION NORM
a State Form 5473 (R21 t 7-25)
It)
Prescribed by the Deparhnent of Local Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
NOTE Telephone, Social Security, drivers license, state identification and federal identification numbers are confidential under IC 6-1.1-12-37"
CERTIFICATION
I (We) le-6, AA td%ta b A /i1om0V_J— certify that I (we) occupied as my (our) principal place of
residence or am (are) buying the f lowi bed real property under contract for which a Homestead Property Tax Standard Deduction is hereby claimed on the
date this application is signed, S 77nZD2.4a (date of signature). I (We).
Oven. [:]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 bust or the right to occupy the property under the terms of a qualified personal residence bust.
[:]Am (are) the shareholder, partner, or member of the entity that arms the property.
INFORMATION
N of Cia'anad (legal name)
Teiepimne Number of Claimant Email Address
(gad )'T 19- 9077
Social Security umber of Claimant st five dulls
River's License I Identification I Other Number of Claimant (last five digits)
(Applicable only if applicant does not have a social security number)
Issuing Stems
2 J41y
Name ofnClairnanfs Spou P n
)p✓
, Q f
Social Security berof G ' s (last five dgdls) River's License I Identification IOhher Number of ClaimnCs Spouse (�st froe nipfs) issuing State
(Applicable only if applicant's spouse does not here a social security number)
4
CONTRACT••1 1
If Buying on Contract, Fee Simple Oumefs Name
Recorder's Office Where Contract is Recorded Record Number Page
PROPERTYDESCRIPTION
County Township T District (city, town, hrwuship)
Parcel Number Legal Description Is
the property
al Properly ❑Annually Assessed Mobile Home (IC 6-1.1-7)
If any portion of the residential structure or the land not exceeding one (1) ace that immedately surrounds that structure is used to produce income, describe the use and portion
of the property utilized to produce income"
PROPERTYOWNED ELSEWHERE BY CLAIMANT
State Couniy
Township Is Claimant Vacating a Homestead?
❑Yes No
I hereby certify the above statements are true, correct, and complete.
SigqatuieofClaimant /1 t
C�!i/
r
Address of Contact (numberand street city, state, d ZIP code)
D2.f5 kI oSu s a n Dr. / ncca
Address of V Homestead, " any (number and street city, state, and ZIP code)
74o 7 0
ASSESSOR USE ONLY
ASSESSEDVALUEHOMESTEAD
VALUE
NONRESIDENTIAL
ngOne (1) Acre trnmedatelyN6ceiidentiM
(1)
mprovement
Other Land
(2)
Total Land (Line 1 plus Line 2)
(3)
Residential Improvements or
Dwelling
(4)
Annually AssesMobile
Garage
(5)
Manufactured Homesed
Other Improvements
(6)
Total Improvements (Line 4 through Line 6)
(7)
Total Value (Line 3 plus Line 7)
(8)
Signature of Assessor
Date Signed (date, , year
hereby certify the above is true, correct, and complete.
Verifying Action —Signature of A r
Date Signed (date, month,year)
)a4 F` _N
STANDARD DEDUCTION ALLOWANCE
For assessment dates after December 31, 2L24: 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 IC 6-1"142 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 OM of the assessed value of the mobile
home or manufactured home.
Signature cf Audito
(Y,lf ��(�
Date Signed (month,day, yew) %�
//J� ram/
ad- (z l' V
J — L ^ G_/ 2_&
DISTRIBUTION: Original —County Auditor, File -Stamped Copy —Taxpayer
age 1 of 3
3
M: N