HomeMy WebLinkAboutHomestead_Harbisona� CLAIM FOR HOMESTEAD PROPERTY TAX
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�) STANDARD / SUPPLEMENTAL DEDUCTION FORM q�
State Form 5473 (R21 17-26) HC10 _lo
Prescribed by the Department of Local Government Finance G.+T
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) 14C^bl certify that I (we) occupied as my (our) principal place of
residence or am (are) bya the fo]IC described real property under contract for which a Homestead Property Tax Standard Deduction is hereby claimed on the
date this�pplicationissigned, LQ -�-��Q _(date of signature). I (We):
[Own. [:]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 owns the property.
INFORMATION
Name o t (legal name)
Telephone Number of Claimant
Email Address
CL
2t3�2 - 89so
Social Security Num laimanl (last five digits)
Drivers License entitication I Other Number of Claimant (last five digits)
Issuing Slate
1
(Applicable only if applicant does not have a social security number)
Name of Claimant's Spouse (legal name)
Social Security Number of Claimant's pouse (last rive digits) Driver's License I Identification I Other Number o Claimant's Spouse (last five digits) Issuing State
(Applicable only if applicant's spouse does not have a social security number)
CONTRACT••. .
If Buying on Contract, Fee Simple Owners Name
Recorder's Office Where Contract is Recorded Record Number Page
PROPERTYDESCRIPTION
Coun
Township
Taxing District (city, town. township)
Parcel Number
Legal Description Is
the pr perty in question:
eat 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 utilized to produce Income.
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PROPERTY
State Coun
Township Is Claimant Vacating a Homestead?
0!::�OQOLC� -ty
j : / ) ❑Yes n o
Signalure'of Claimant ..
I hereby certify the above statements are true, correct, and complete.
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t
1: .
Address of Contact (number and street, city, s e, and ZIP code)Address f Va d Homestead, if any (number and street, city, state, and IP code)
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ASSESSOR USE ONLY
ASSESSED VALUE HOMESTEAD VALUE NON RESIDENTIAL VALUE
Land Not Exceeding One (1) Acre Immediately (1)
Surroundin ResidentialImprovement
Other Land
(2)
Total Land (Line 1 plus Line 2)
(3)
Residential Improvements or
Dwelling
(4)
Annually Assessed Mobile l
Garage
(5)
Manufactured Home
Other Improvements
(6)
Total Improvements (Line 4 through Line 6)
(7)
Total Value (Line 3 plus Line 7)
(8)
I hereby certify the above is true, correct, and complete.
Signature of Assessor
Dale Signed (date. month, year)
0
Verifying Action —Signature of Auditor
QV * 6
Date Signed (date, month, year)
11 ncl
STANDARD.ALLOWANCE
For assessment dates after December 31, 2024: in 2025.
20 Pay 20 $48000; in 2026. $40,000; in 2027, $30,000; in 2028, $20.000;
in 2629, $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 6-1.1-12 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) ,
s
DISTRIBUTION: Original — County Auditor, File -Stamped Copy — Taxpayer V
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