Homestead_Ingler '4,4. CLAIM FOR HOMESTEAD PROPERTY TAX YEAR.
cis t STANDARD / SUPPLEMENTAL DEDUCTION FORM
State Form 5473(R13/12-09)
HC10
,ei� Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for filing instructions.
• - CERTI�FICATITIO�N STATEMENT . - - -
I(We) . IC as C' • i�71•i���7� �U certify t':t I( _. Ai:. .• r.:WIr)principal
place of residence ,tam(are)buying the foll./Ring describ-=real property for which a :.mestead Property Tax Standard Deduction is hereby claimed
under contract on the date this application is filed, (date of filing). I(We): AUG 2 7 2014
E Own ❑ Am(are)buying under recorded contract
❑ Am (are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation a/h/f/�Y�!§�
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualifiedp rson L N UDITOR
❑ Am (are)the shareholder, partner or member of the entity that owns the property.•
. -+ :`t .' - _ ,;Y{ .-r CLAM-- TS INFORMATION"s __ s" ..4:1-r-4---- - _ :-----i-,:- ,,;i
/
If buying on contract,Fee Simple owners name
Recorders office where contract is recorded Record number Page
- PROPERTY:DESCRIPTION -- -
County Township Taxing district(city,t township)
t ', '�
v �`',,,'"I •
Parcel number Legal description I Is the rty in question:
❑ al property ❑ Annually assessed mobile home(IC 6-1.7-7)
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.
24,-/9-3 / - /oo oco . 233 - Oa f
. - - 4:.; �P,ROPERTYOWNED 3Y CLAIMANT IN OTHER COUNTIES e C - - v County Township County I Township
•
I hereby certify the above statements are true,correct and complete.
Sign v of`claitma��\n!�!�!`t1y1y1y---��� 141
Address(number and street,city,state,and ZIP code) k �V` V._9/
CA10 S2- w •ub to , 1N 1h_ q
�` ASSESSED,NALUE HOMESTEAD NON-RESIDENTIAL
ASSESSORUSEONLY T TRUE TAX VALUE. "AT..100%OF_TTV :._VALUE - VALUE Land not exceeding 1 (one)acre Immediately
-surrounding residential improvements. (1) •
Other land (2)
Total land(line 1 plus line 2) (3)
Dwelling (4)
Residential improvements or Annually
Assessed Mobile/Manufactured Home Garage (5)
Other improvements (6)
Total improvements(line 0 through line 6) (7)
Total value (line 3 plus line 7) (8)
hereby certify the above is true,correct, Signature of Assessor Date signed(month,day,year)
I and complete.
Verifying action-Signature of Auditor Date signed(month,day,year)
' - - STANDARDOEDUCTIONALLOWANCE - _
20 pay 20 Lesser of 60%of the assessed value of the homestead or$45,8 : - - . ' '-,
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 AA 2 7 2014
one-half(1/2)of the assessed value of the mobile home or manufactured home. 1
Signature of Auditor n, ate si (month,day,year)
GltiSUN�/LfCOOUNTY AUDITOR
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDITISTANDARD DEDUCTION
t State Fortn 5r73 (R6 / 4-03)
PrescriDeE by Na Department of Local Govemment Finance
INSTRUCTIONS: See 2verse side lor (ling instnections.
FORM �-) YEAR _
� HC10
�
- -:ia:�'�', � .
��e) �� certify that o e 7st da�y� f arch, 20
I(We) occupied as our princip I lace of residence the Ilowing described real propeAy (or which a Homestead Proper�PC�eQtCi�by daimed:
❑ I(VJe) owned ❑!ve buying under contract pIBSON C UNTY AUDITOR
' Have a benefidal interest in ihe entity ihat is liable (or ihe property taxes on the property and that owns ihe property or is buying under a conVact.
If buying on contrad. Fee Simple owners name
Recordefs olfice where wnUaU is remrded
5�V-�r.-.r�—'.��'�-;'�� �:t2��L'�:1�`�5�'�""�"`'s
County Toxnship
Tacing dislrict (ci�towg, township)
RecorO number � Page
Parcel number Legal description Is
�I�o?/'��.�y� property in question:
lo r!['J �^'l/L� W a�-o a y ❑ Real property ❑ Mobile Homo (/ C 61. f-n
If any portwn ol Ne residentfal sW cture w the land not exceeding one (1) acre that immediatety wrrounds that swcWre is used b produca income, tlesaibe Ihe use and portlon
ol lhe property utiGzed b produte income.
� A�I.J 31-3-lD Iqc.
20_Pay20_
lesser of tr2 Nomestead
vawauon or 535.000
SgnaWre
5