HomeMy WebLinkAboutHomestead_Henning,A-7"j& CLAIM FOR HOMESTEAD PROPERTYTAX
x eid �c STANDARD / SUPPLEMENTAL DEDUCTION
1 State Form 5473 (R21 17-25)
Prescribed by the Department of Local Government Finance
FORM YEAR
HC10I au
INSTRUCTIONS See reverse side for filing instructions.
NOTE: Telephone, Social Security, driver's license, state identification and federal identification numbers are confidential under IC 6-1.1-12-37
CERTIFICATION
I (we) L- f S certify that I (we) occupied as my (our) principal place of
residence or am (are) buying the fo ing tolled real contract for which a Homestead Property Tax Standard Deduction is hereby claimed on the
date this application is signed, v '- -a.� Q . (date ofsfgnature). I (we):
❑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, partrw, or member of the entity that owns the property.
INFORMATION
Name of (legalname)
L-(S�
oreN� laimanEmaAdd
t't����rassg
Social Security Number of Claimant past ) '
uirvers License I Identification I Other Number of Ctaimant (last five d'pits) 7ssuing
(Applicable only d appricant does not have a social security number)
State
Name of Claimant's Spouse pegat name)
Social Security Number of Ctaimanfs Spouse past live digits) Dnvets License I Identification I Other Number of Clainanfs Spouse past five dpfs) Issuing State
(Appf—ble orrly AappficanPs spouse does not have a social security number)
CONTRACTRECORDED
If Buying on Contract, Fee Simple Owners Name
Recorders Office Where Contract is Recorded Record Number Page
PROPERTYDESCRIPTION
Ccu ty Township Taxmg District (city, town, township)
Parcel Number Legal Description Is
the Pm in question:
®ReProperty ❑ 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 ut3Fed to produce income.
t�-►����—act—tea �LQ Ic
PROPERTYOWNED ELSEWHERE BY CLAIMANT
State County
Township Is Claimed Vacating a Homestead??
❑ Yes ®TSo
Signature qhClaftant ,
I hereby certify the above statements are true, correct, and complete.
Addre's'ts of Contact (number and ssfree41city, state, and ZIP cccood-ee))�}-
Ad of Vacated Horn If any (number and street - rid ZIP code)
ASSESSOR USE ONLY ASSESSED VALUE
HOMESTEADVALUE
NONRESIDENTIAL VALUE
Land Notceed>idiatel
(t )
SndmResO(mAermy
Other Land
(2)
Total Land (Line 1 plus Line 2)
(3)
r -T
Residential Improvements or
Dwelling
(4)
.
Annually Assessed Mobile I
Garage
(5)
Manufactured Home
Other Improvements
(6)
�Ol"
Total Improvements (Line 4 through Line 6)
(7)
Total Value (Line 3 plus Line 7)
(8)
ON
Q
I hereby certify the above is true, correct, and complete.
Signature of Assessor
year)
gvDJ
Verifying Action - Signature of Auditor
Date Signed (date, , year)
STANDARD DEDUCTION ALLOWANCE
For assessment dates after December 31, 2024: in 2025,
20 Pay 20 $48,000; in2026, $40,000; in 2027, $30,000; in2028, $20,000;
in 202g, $10,D00; 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 real property may not exceed one-half (f2) of the assessed value of the mobile
home or manufactured home_
Signahr2 or uditor
�
Date Signed (month, day, year)
.
cal—CgLo
((
D1;18UTION: Original -County Auddor,RleStamped Copt' -Taxpayer (I ^
Pagel of 3 I^y,-�`l/��`��
X