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Homestead_Stunkel (9)CLAIM FOR HOMESTEAD PROPERTY TAX STANDARD / SUPPLEMENTAL DEDUCTION State Fwm 5473 (R12 / 6-09) '' / aresa;bea ny u,e oeDartrtrem w L�ai cm.ertmem Fire�ce INSTRUCTIONS: See reverse sitle /a �ng instiuctions. l�P� FORM HC70 � YEAR � � . � . ��e) ' th I(� ed as Y(o ) Prinapal place of sidence or am (a buying Ne following described real property for which a Homestead Property Tax Standard Deduuion is ereby daimed � under mntract on ihe date is applinlion is filed, (date of filin 9� DEC 2 9 ZO10 ❑ I(We) own ❑ Am (are) huying under recorded mntract ❑ Am (are) enfitled to occupy as a tenant-stockholCer of a cooperaWe housing corparation r�r � Have a beneficial interes[ in the Wsl or the right to occupy ihe pmperty under the tertns of a qualified persorf Va le�d�t •• • • • ••� � H brymg m mntrac� Fee Simple owneYS reme Recordeh ottce where convaa u remNed Recortl num6rs Page . ..�. . � , � Counry Township T' CiStrict (ci(y, (pwn. townshi ) Parcel number L al desaiption �, (p s/� Is Ne pmperty m question: � — // E y-3- b � ProPertY ❑ AnnuaAy essessetl mod'le home (IC 6f. f-n �7 any ponion d the regden�lal sWCwre or ihe WM not axceetli� me (7) aae Ihaf unrt�ediately surmunES tnac sN�re is used to p�odwe inmme, aescnbe the use antl ponion of Ne pmperry uCSred to prt�tlure inrane. prt tl o1G=/9 3� aoo-6oa. 3�5'-oa� -.. . , : . . Counry . To.mship ' Caunb Tawnship I hereby certiy the above slatements are We, correa and complete. Sg�wre ot daimam � i Address (num6er aM sheef, lily, state, entl LPmEe) X 3s� E � �- > ,. ,� , . ., . , „.. � Land not ezceeding 1(one) acre Immediatey � ���<"���!{e: ��'��-5i���� surtoundin residential im rovements. (� 3� ��, Otherland (Z) . }��n�� `^� +=!�s7ti'� j'.}'•'�t'.-. -���'s.�, Tofal land (line 1 plus line 1) (g� ' Dvreiling (4) ��°`�"+�4���''sr:s �s�i ResitlenUallmprovemenborMnualty �.- `�+ Assessed Mobile / ManufacWred Hame Garage (5) . y`-�`�Y'S,ti,y`.,. �'�`'"-'*% ;'S-` �'; �r�t t�' � t <.-��-�5v��� Other Improvemems • (B) �'-3'L`d'' ��" - �:_r��Y';?Y..�_�.s Tatal improvemen� (Ilne s fhrougAline 67 (7) ' ToUI value (llrre 3 pfus fine 7) (g) I hereby certity the a6ove is We, �ortect, SignaN�e of Pssessor � Data signed (month, day, yae� and complete. vaay�q aaor� - sy�n�re aa,a�mr Date signed (man/h. EaY. Yee� � �.•. � � . . 20 _ pay 20 Lesser of 60% of Ihe assessed value of the homestead or $45,000 NMaitAstaMUg any Wherpmvision, Ne sum of the tletlucliw�c proNtled in IC 61.1-71 fo e mob�7e lpme Nal is $ nol essesmd es real properry or lo e manu/aUUred hana Nat k nof essessed as reel properry maY rm! exraed one�haX (1R) W fha assessetl rdlueW Ihe mobi/e Aome ormanu7actured hane. Sg�uture otAuditw � Date signed (rtimlh. daY. Y�