HomeMy WebLinkAboutHomestead_Scott (2)fflCLAIM FOR HOMESTEAD PROPERTY TAX STANDARD / SUPPLEMENTAL DEDUCTION FORM ^YEAR
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State Form 5473 (R21 /7-25) HC10 D(,
=% Prescribed by the Department of Local Govemment 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) ex-- 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
—I
date this application is signed, - IS- eZCp . (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 of Claimant (legal name
Telephone Number of Claimant Emall
Address
13 u� t
1 ��l Or1- 103
Social Security Number of Claimant (last five digits)
Driver's License I I enulicavon I Other Number of Claimant (last five digits)
(Applicable only if H t does not have a social security number)
Issuing State
2,-
Name of Claimant's Spouse (legal name)
Social Security Number of Claimant's Spouse (last rive digits) DrivelsLicense/ Identification / Other Number of Claimant's Spouse (last five digits) Issuing State
(Applicable only if applicant's spouse does not have a social security number)
CONTRACTRECORDED
If Buying on Contract, Fee Simple Owner's Name
Recorder's Office Where Contract is Recorded Record Number Page
PROPERTYDESCRIPTION
C my
Township
Taxing District (city, town, township)
I,bso _
eX,
Parcel Number
Legal Description Is
the property in question:
®12ea1 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.
i-3---25
PROPERTY
Slate County
Township Is Claimant Vacating a Homestead?
❑ Yes D118
Signet _ iman
I hereby certify the above statements are true, correct, and complete.
Address of Contact (number and street, city, state, and ZIP code)
Address of Vacated Homestead, if any (number and street, city, state, and ZIP code)
'A-t `l� .
ASSESSOR USE ONLY
Land Not Exceeding One (1) Acre Immediately
(1)
Surrounding
urroundin Residential improvement
Other Land
(2)
Total Land (Line 1 plus Line 2)
(3)
Residential Improvements or
Dwelling
(4)
Annually Assessed Mobile /
Manufactured Home
Garage
(5)
Other Improvements
(6)
Total Improvements (Line 4 through Line 6)
(7)
Total Value (Line 3 plus Line 7)
fie)
Irl
AVp1 Vo
Signature of Assessor N GJbYd
Signed (date, month, year)
I hereby certify the above is true, correct, and complete.
G\—
Verifying Action — Signature of Auditor Date Signed (date, month, year)
STANDARD DEDUCTION
For assessment dates after December 31, 2024: in 2025,
20 Pay 20 $48,000; in 2026, $40.000; in 2027, $30,000; In 2028, $20.000:
in 2029, $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 -hall (112) of the assessed value of the mobile
home or manufactured home.
Signature of Auditor
-
Date Signed (month, day, year)
1
1�—> _ QLP
--1 —
1
1
DISTRIBNON: Original — County Auditor, File -Stamped Copy — Taxpayer L/
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