HomeMy WebLinkAboutHomestead_Rexing (2)CLAIM FOR HOMESTEAD PROPERTY TAX
STANDARD I SUPPLEMENTAL DEDUCTION
y State Form 5473 (R2117-25)
Prescribed by the Department of Local Government Finance
FORM YF�R
HC1D
INSTRUCTIONS_ See reverse side for filing instructions.
NOTE Telephone, Social Security, driver's license, state identification and federal identification numbers are confidential under IC &1.1-12-37.
CERTIFICATIONar
I (We) 12 777Z d lle n certify that I (we) occupied as my (our) principal place of
residence or am (a ) buying following described real p under contract for which a Homestead Property Tax Standard Deduction is hereby claimed on the
date this appfrcation is signed, �f �' �l� 2 �o (date ofsWature). I (We):
' 3Vwn. ❑Am (are) buying under recorded contract.
[:]Am (are) entitled to occupy as a tenarft-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 axes the property.
INFORMATION
Name of Claimant Pag�—�Telleeph�olne Number of Claimant Email Address
-
14
Sodal Security Num
4-® /J4
Diver's License I Identification I Other Number of Claimant (last five dgis)
(Applicable only ff applicant does not have a sonar security number)
Issuing State�j
Name of Claim s 0 name) 1'%
Soda) Security Numberof Cieinmrts Spouse iSke dgils) Divers licarsellderSfication/Other Number ofCLanrs Spouse(tad five dypts) Issuing State
(Appr ble only eAppixont's spouse does not have a sodaf secwly number)
-a _I
MINE
CONTRACT RECORDED
MENEM
If Buying on Contract Fee Simple Owner's Name
Recorder's Office Where Contract is Recorded Record Number Page
PROPERTYDESCRIPTION
County U ``
6( sc—, L
7owmslti Taxing District (dry, town, township)
tip CV(,
Parcel Numbber
Legal Description Is
the property in question.
�/ 3
l ""w{J 2 L' / oD "ter •1
-.3-0 15 QE3
Real 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 Property, utazed to produceincome.
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State County
Tow•rmhip Is Claimant Vacating a Homestead?
❑ yes No
true, correct, and complete.
Signature of Claimant
(� t
I hereby certify the above statements are
Address of Contact (numberand street " ,state, and ZIP code
Address of Vacated Homestead, if any (numtxr sties , state, and LP mite)
,4r�bsJA6&, J�7
�9
ASSESSOR ONLY
1
• 1
. 1
Land Not Exceeding One (1) Acre Immediately
(1)
Surrounding Residentiallm meFit
Other Land
(2)
Total Land (Litre 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)
(7)
Total Value (Line 3 plus Line 7)
(8)
Signature of Assessor
Date Signed (date, month, year)
I hereby certify the above is true, correct, and complete.
Verifying Action —Signature of Auditor Date Signed (date, month, year)
STANDARD DEbuCTION ALLOWANCE
Far assessment states after December 31, 2024: in 2025,
20 Pay 20 $48,000, in 2026, $40,000; in 2027, $30,000; of 2028, $20,000;
in 2029, $10,000; and beguming with the 2030 assessment date
and for each assessment date thereafter, $0. $
Notwithstanding any other provision, the sum off 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-haH (i2) of the assessed value of the mobile
home or manufactured home.
Si of Auditor
Date Signed month, day, year)
DISTRIBUTION: Original — County Auditor, FleStamPed Copy—Taxpey
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