Homestead_Dunkel _ CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
STANDARD! SUPPLEMENTAL DEDUCTION j_
-54-3 HC10 `Z4
!a•-' cri Presbed by Me Department of Luca Oc.er--e-,r,a-- - O ` •
INSTRUCTIONS:See reverse side for filing,nstruchons
NOTE Telephone.Social Security,drivers license state identification and federal ioentEcat on numbers are confidential under IC 6-1 1-12-37.
1� CERTIFICATION STATEMENT
I(Wei \r\ ---- —cert tra'I Ire,c rccc. e r-
res�derc-.•,(are!baying the fog rig dent'bed re_ c " -- -_- -_ - -s c-estead Property Tay.Sta-_,1::::Ge_ - e
dat ,s app:icat:cn:s sgned _ ____ _.. _
.lane,enht',ed to occupy as a tenan-st;-:i-= o`a cc-ope-a;.= c_s __._. :.. '
❑Ha.e a berehca;:rterest in tie trust cr e _ .xcupy tie p'oceri, _ -_ -' ;-'a- ._.. i
0 Am(are;the shareholder partner,or me-Le t-e ent.ty that oars ire property
i 4 Buy'ng on Contract Fee Sample Owne's Name
Reda:lers Office Where Contract-s Recorded _-. :Reso•s'.amter r oa;e
PROPERTY DESCRIPTION
County `(� Towns",p Q y •
_--_
ca•ce,‘.4., er J V 1Lega:Destnpta r//✓'ll_,I}` - r:__-- ..
• I Rea.R,;t ❑.�--..3,y.:5SCSie".':-C.� _
if any co.-ton of tee res•de-na'stract.re or the ta-d rot e.reed n•g ore!I.acre:^s -•-- ---•s;--- a `a•.s• .-._-•c=`"a.=e-come descab•the.se a-d ooc dr
of the prate'.,at'.-zed tc prod;.ce•rccme
I 2 6 - 2`. -07- o- 00Q 27-3 - o -21.4_ ..
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State County,and Townsnlo _- ,-atn; omestead''
I hereby certify the above statemects are true correct and complete
Aod•ess= :anat.': r-.moor and sloe. c,:/ state and Z�__.i --- _-s.f.sza•e^. _,•-1_ a • "-re-ar_ _t c::/ abate ar s:Z _ a=
ASSESSOR USE ONLY I ASSESSED VALUE I HOMESTEAD V^'IIE NON RESIDENTIAL VALUE
Land Not Exceeding One(1)Acre Immediately 11 i
Surrounding Residential Improvement
Other Land 12
Total Land(line 1 plus line 2) t 3_—
1--- .' N'.Vi."
Residential Improvements or Dwelling Ii4• `fl %
. Annually Assessed Mobile I -- ��J
Manufactured Home ' Garage ``e J�i/�/}'yL4¢
Other Improvements i(6, jps /j� y' \S
Total Improvements(Line 4 through Line 6) (J�1.��1 P
Total Value(Line 3 plus Line 7) t8' 0a
5,;rata_o Assessc- G\jf\eb Cate S; e.:date morm yea.,
I I hereby certify the above is true.correct.and complete
1 --
'Verfy.r;Acton-5-g^ar-are of Aid to _ _- Care Speed late •ncrtr ens,
STANDARD DEDUCTION ALLOWANCE
20 Pa. __estead c _4_ " -
Nol s.tnstanding end otnerprn.'s•cn the sa-ri cf:re deducncrs pnc:'ced,r 5-, r-r2.c,T^,c..e _-_ 3
,s not assessed as real proper/or to a manufactured tome that s not assessed as-ear„rocer', -
exceed ore-half r r,2 of the assessed value of trio moo"e rune;,r nufa ' _d nano
Sicra•re cf Aadaor /nu)
_ate S g e.. •-cr d Ear
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fil\
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DISTRIBUTION .:It,rat-Cdint,-.. - _•• _ de- _-• Iv a,ca
age 1of2
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