HomeMy WebLinkAboutHomestead_Dougan (2)e CLAIM FOR HOMESTEAD PROPERTY TAX
STANDARD / SUPPLEMENTAL DEDUCTION FORM / YEAR
Stale Form 5473 (R21 17-25) HC10 0� �
Prescribed by the Department of Local Government Finance
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) certify that I (we) occupied as my (our) principal place of
residence or am (are) buying the followinj 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 (We):
1U/ 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 of Claimant (legal name)
Telephone Number of Claimant
Email Address
? ,XG s,
(80 I-157-0531 I
Social Security Number df Claimant fast rive digits)
Drivers License I Identification Other Number of Claimant (last five digits)
Issuing State
01'79 (�7 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 Spouse (last five digits) Drives License Identification I Other Number of Ctaimanrs 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
PROPERTY DESCRIPTION
County
Township Taxing District (city. town, township)
Parcel Number
Legal Description Is
the roperty in question:
1 — �. 3
—
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 utilized to produce Income.
PROPERTYOWNED
State County
Township Is Claimant Vacating a Homestea
❑Yes No
I hereby certify the above statements are true, correct, and complete.
Signatur atm nt
Address of Contact (number and street, city, state, and ZIP code)
Addres f Vacated Homestead, if any ( mber and street, city, state, and ZIP code)
{doe. ?(f,r ��R,
77O
n
ASSESSOR USE ONLY
Land Not Exceeding One (1) Acre Immediately
ASSESSED VALUE
(1 )
HOMESTEAD VALUE
Surrounding Residential Improvement
Other Land
(2)
Ap
Total Land (Line 1 plus Line 2)
(3)
Residential Improvements or
Dwelling
(4)
Annually Assessed Mobile
Garage
(5)
J
Manufactured Home
Other Improvements
(6)
9
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
Date Sign ,{ctgt onffi�yet
Verifying Action —Signature of Auditor
Date Signed (date, mo 11101
STANDARD DEDUCTION ALL
•
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)
DISTRIBUTION: Original —County Auditor, File -Stamped Copy — Taxpayer t
Page 1 of 3
d
U