HomeMy WebLinkAboutHomestead_Crisp01; CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
STANDARD / SUPPLEMENTAL DEDUCTION FORM
•y Slate Form 5473 (R21 /7-25) HC10
-• Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for tiling instructions.
NOTE: Telephone, Social Security, driver's license, state Identification and federal Identification numbers are confidential under IC &1.1-12-A7
CERTIFICATION
M
I (We) 1C AC r J ���r 1 C C certify that I (we) occupied as my (our) principal place of
residence or am (are) IJ lying the following described real p perty under contract for which a Homestead Property Tax Standard Deduction Is hereby claimed on the
datethis application Is signed, (date ofslgnature). I (We):
0fin• [:]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 trust.
qualified personal residence
❑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
Social SecudtyX4 umber of Claimant (last five digits) It
rivers Ljcens5 I Identlucauon i Other Number of Clamant (last ve digits)
(Applicable only If applicant does not have a social security number)
Issuing State
ry
Name of Claimanrs Spouse (legal name)
Social Security Number of Claimants Spouse (last five digits) D rs rise Identification or umber of Claimants Spouse ilast five digits) Issuing State
(Applicable only i/applfcanfs 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
PROPERTY DESCRIPTION
County
Township Taxing District (city, town, township)
Parcel Number
Legal Description Is
the property in questlon:
Lr�r 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) arre that immediately surrounds that structure Is used to produce Income, describe the use and portion
of the property utilized to produce Income.
cco
PROPERTY
Slate County
Township Is Claimant Vacating a Homeste d?
❑Yes QNo
I hereby certify the above statements are true, correct, and complete.
Signature of Claimant
e
Address of Contact (numberand street, city, state, and ZIP co a)
Address of Vacated Homestead, t ny (number and sire , city, stale, and ZIP code)
�C;•
Land Not Exceeding One (1) Acre immediately
(1)
SurroundingRes idenFJaIIm rovement
Other Land
(2)
Total Land (Line 1 plus Line 2)
(3)
Residential improvements or
Dwelling
(4)
JL
Annually Assessed Mobile /
Garage
(5)
Manufactured Home
Other Improvements
(6)
UCf0
2026
Total Improvements (Line 4 through Line 6)
(7)
Total Value (Line 3 plus Line 7)
(8)
Signature of Assessor
I hereby certify the above Is true, correct, and complete. GIBSONCO
S year)
JNTYAUDITOR
Verifying Action —Signature of Auditor
STANDARD DEDUCTION ALL
Dale Signed (date, month, year)
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 provWon, the sum of the deductions provided In IC 6-1.1-12 to a
$
mobile home that 1s 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
Data Signed (month, day, year)
i
1
DISTRIBUTION: Original — County Auditor, File -Stamped Copy — Taxpa§er
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