HomeMy WebLinkAboutHomestead_Sollman (2)CLAIM FOR HOMESTEAD PROPERTY TAX FORM YF11R
STANDARD I SUPPLEMENTAL DEDUCTION HC10
State Form 5473 (R2117-25)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for fling instructions.
NOTE Telephone, Social Security, driver's ficense, state identification and federal identification numbers are confidential under IC 6-1.1-12-37.
CERTIFICATION
I (We) r Q (.. Sot 1 m' .W certify that I (we) occupied as my (our) principal place of
residence or am (are) buying the following described real property under contract for which a Homestead Property Tax Standard Deduction is hereby claimed on the
date this application is signed, (date of signature). I (Way.
to-56. []Am (are) buyng under recorded contract.
❑ Am (are) entitled to occupy as a tenant-stoWiolder 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 properly.
INFORMATION
Name o, Claimant ()cgaf name) Telephone Number of Clahnant Enlal Address
Tma. b P11P>4W ( 812) 550-7105
Social Security Number of Claimant (last five dgRs) Divers Licence I Iden0cahon I Other Number of CFaimant (last five digits) [Ming State
(Applicable only if applicant does not have a social security number) /f /'3
Name of Claimants $Douse (regal morn)
It Buying on Contract, Fee Simple Owners Name
Recorders Office Where Contract is Recorded
State -
spouse does not have a social securty number)
Record Number I Page
Towrdti Taxing District (city, town, township)
7County ��
�11h5onl d%a5on LLOA! �Ckn5art Turns
Pared Number I Legal Des/edption Is the property in question:
/ _ / 9. 7 7 Q0- . LL�' D l t/ ed Property ❑ Annually Assessed Molxle None (IC 61.1-7)
Iffany Oportion of✓the erresidential.i/structure or the IazM no exceeding
am
7(1) ace Mat irnmedUABN surrounds brat structure is used to produce income, describe the use and portion
of the property utilized to produce income.
State County Township I Is Clad an Y acating a Honestead7 I
hereby certify the above statements are true, wired, and complete. '
Address of Contact (number and sbee� city, and ZIP code) ,�/� Address of Va , d ( bar and steel , state, and ZIP code)
ASSESSOR USE ONLY ASSESSE , VALUE HOMESTEAD VALUE I NON,
Land Not Exceeding One (1) Aae Immediately (1j
Surroatdin Residettiallm Tent
Other Land (2) Oak
Y-1 I .-A it inn 1 nh,c 1 inn 91 131 L...�l
Residential Improvements or
Dwelling
(4)
Annually Assessed Mobile
Manufactured Home
Garage
(5)
Other Improvements
(6)
Total Improvements (Line 4 through Line 6)
(7)
Total Value (Line 3 plus Line 7)
(8)
LT
Signature of Aasesaor
Date Signed (date, non ,
1 hereby certify the above is true, correct, and complete.
Verifying Action -Signature of Auditor
Date Signed (date, month, year)
STANDARD DEDUCTION ALL
For assessment dates oiler December 31, 2024: in 2025,
$48,000; in 2026, S40,000; in 2027, $3Q000; in 2028, $20,000;
20 Pay 20
in 2029, S70,D00; and beginning with the 2030 assessment date
and for each assessment date thereafter, $0_
$
NodwWWandng 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 (112) of the assessed value of the mobile
home or manufactured home.
Signature of Auditor
Date Signed (month, day, year)
DISTRIBUTION: Original -County Auditor, FiIEStamped Copy -Taxpayer ��
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