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HomeMy WebLinkAboutHomestead_Walker (2)CLAIM FOR HOMESTEAD PROPERTYTAX d' STANDARD / SUPPLEMENTAL DEDUCTION State Form 5473 (R21 / 7.25) Prescribed by the Departmentof Local Government Finance FORM YEAR HC10 INSTRUCTIONS., See reverse side for riling instructions. NOTE: Telephone, Social Security, driver's license, state identification and federal Identification numbers are confidential under it a-f 1_19-a7 CERTIFICATION (we)a L' 4 1 1 < ` (' j n \'tf l certify that I (we) occupied as my (our) principal place of resider a or am (are) buying the following described real property under contract for which Homestead a Property Tax Standard Deduction is hereby claimed on the dat this application Is signed, (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 properly. INFORMATION Name of Claimant pagal name) r_r Telephone Number of Claimant Email Address Sbdal Security Number of Claimant past five digits) Dwer s License I Idenulicauon i umer Number of Clamant ast five g s) (Applicable only If applicant does not have a social security number) Issuing State Name of Clalmanfs Spouse (legal name) Social Security Number of Clalment's Spouse past five digits) D ers as Idenbfica6on O m Woiim of Cl mansbpouse(asr edrg"s) Issuing State (Applicable onlyit applicants spouse does not have a social secur tynumber) zz CONTRACT• . If Buying on Contract, Fee Simple Owners Name Recorders Otfice Where Contract Is Recorded Record Number page PROPERTYDESCRIPTION CountyM Townshlp Tazing District (city, town, township) Parcel Number Legal Description eA P Is the property In question: ©i Real Property ❑ Annually Assessed Mobile Home (IC 6A.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 ulllized to produce Income. 1-1C) -C)CA . 0-�s3-0'q;F� PROPERTY Stale County Township Is Clalmant Vacating a Homestead ❑Yes LONo I hereby certify the above statements are true, correct, and complete. ura of Claimant / Zdress Address of Contact (number and street, city; state, and ZIP code) z�— of Vacated Homestead, if any (number and street city, state, end ZIP code) ASSESSOR USE ONLY Land Not Exceeding One (1) Acre Immediately Surroundin Resfdentiallm rovement ASSESSED VALUE HOMESTEAD VALUE (1) Other Land (2) Total Land (Line i plus Line 2) (3) Residential Improvements or Dwelling (4) Annually Assessed Mobile / Manufactured Home Garage (5) 4 Other Improvements (6) Total Improvements (Line 4 through Line 6) (7) Total Value (Line 3 plus Line 7) (8) �j r I hereby certify the above Is true, correct, and complete. Signature of Assessor COUNTYAUD) Signed (date, month, year) Vedfying Action — Signature of Auditor STANDARD DEDUCTION ALL Date Signed (date• month, year) For assessment dates after December 31, 2024: in 2025, 20 Pay 20 $48.IN; 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 provislon, the sum of the deductions provided In IC 6-1.1-12 to a $ mobile home that is not assessed as real properly 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 n J Dale Signed (month, day, year) .�..,rF / .na, mou run; Lingmai— county Auditor, File -Stamped Copy —Taxpayer Page 1 of 3