HomeMy WebLinkAboutHomestead_Benton (3)AA, CLAIM FOR HOMESTEAD PROPERTYTAX
1I\z STANDARD / SUPPLEMENTAL DEDUCTION FORMS
\�ea State Form 5473 (R21 17-25) HC10
Prescribed by the Department of Local Government Finance
INSTRUCTIONS. See reverse side forfiling instruction_
NOTE Telephone, Social Security, driver's license, state identification and federal identification numbers are confidential under IC 6-1.1-12-37.
CERTIFICATION
(Are) LI't {" r ' ! > (_F J( ,f i ,` i t 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 ofsignature). I (We):
Am m. [-]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 cans the property.
INFORMATION
N of Claimant (legal name?__
/T Done Number of Claimant -.ag
Address
/LC-�:iv G
(6/�Q ,1 �-
Social Security Number of Claimant least he digits)
Crivers License 1 Identification Other Number of Claimant (last five digv[sJ
(Apptiea opy d •pplxant does not have a social security numbed
lssuin9 State
! r
Name of Claimanrs Spouse (tgal name)
Social Security Number of Claimants Spouse (last five digits) Druees license I Identification i Other Number of Claimants Spouse (lastfive digits) Issuing State
(Applicable only if applicant's spouse does not have a social seourdy number)
CONTRACTRECORDED
If Buying on Contract, Fee Simple Owners Name
Recorders Office Where Contract is Recorded Record Number Page
PROPERTYDESCRIPTION
County ! Tow94hip-+ i Taxing District ( to towmh
R.: no, =i`, =t;[ � l�.";
1-�J rJ;.✓�/'fG'l
(
Parcel Number Legal
Description Is
the property in qugsb ,.
❑ Real Property i ' Annually Assessed Mobile Home (IC 6-1.7-7)
If any portion of the residential structure or the land not exceeding one (1) acre that i nmedrately surrounds that structure is used to produce income, describe the use and portion
of the property utSzed to produce income.
` �j 1
- � � :=C 1 -- � �� - ��C f -610 r
s
PROPERTYOWNED ELSEWHERE BY CLAIMANT
State
County
Township Is Claimant Vacating a Homestead?
^FiNo
❑yes
Signailime IN Claimant
I hereby certify the above statements are true, correct, and complete.
Address of Contact rrlomberp!ff s eet, dty, state, and pcode% �y V_�
of Vacated Homestead, ill any (number end street dty, state, and ZIP code)
ASSESSOR USE i•fl-ASSESSED VALUE HOMESTEAD VALUE NONRESIDENTIAL
Land Not Exceeding One (1) Acre tt VIatety (1)
SurroundingResidentiallm merit
Other Land
(2)
Total Land (Line 1 plus Line 2)
(3)
Residential Improvements or
Dwelling
(4)
Annually Assessed Mobile I
MAY
Manufactured Home
Garage
(5)
Other Improvements
(6)
Total Improvements (Line 4 through Line 6)
(7)
Total Value (Line 3 plus Line 7)
(8)
5O
L, v
I hereby certify the above is true, correct, and complete.
Signature of Assessor
Date r a40
/%R
Verifying Action -Signature of Auditor Date Signed (date, month, year)
STANDARD DEDUCTION ALL
For assessment dates after December 31, 2024: in 2025,
20 Pay 20 $48.000; in 2026, $40,000; in 2027, $30,D00; in2028, S20,0D0;
in 2029, $10,000; and beginning with the 2030 assessment date
and for each assessment date thereafter, $0.
S
Notwithstanding any other provision, the sum of the dedulions 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 leaf property may not exceed one-haff (112) of the assessed value of the mobi7e
home or manufactured home.
Date ed 1t. d j
DISTRIBUTION: Original -County Auiddor, FileStamped Copy -Taxpayer"' j
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