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HomeMy WebLinkAboutHomestead_BinhackCLAIM FOR HOMESTEAD PROPERTY TAX � _ STANDARD/SUPPLEMENTAL•DEDUCTION State Fortn 5473 (R12 / 6O9) �O f• Presrn6 by Na Pepartmerit o( Local Go e n rtianca � INSTRUCTIONS: See �rse side lor � � � rg � stnictions. FORM HC10 YEAR � •, . � M'e) ��t3re) ocwpied as my (our) prindpal place o residence or am (are) buying the following described real property (or which a Homestead Property Tax Sfandard Detlucfion is hereby daimed under contrap on Ihe date �his appliralion is filed, � (date o/ filin 9) C .'J. . ❑ I(We) own ❑ Am (are) buying under recorded contract � ❑ Am (are) entilled [o ocwpy as a tenant-stockholder of a cooperetive housing corpor�{'%SON COUNTY AUDITOR � Have a beneficial interest in Ihe Wst or Ihe right to occupy the property under the tertns of a qualified personal residence Wst ' Name a(daurum's spouse F��^N �� If buyin8 m contrad, Fee Simple awners name Reooideh of6ce where mntract u recordeA Counry Township Drimrers ficense / Identi;rat of daimant (lasf five d'g'dsJ omrls Ikerte / Itlentiiralion / Olher num6er of daima�rt's sGO�� (WSf fivB dg'2s) town, townshiP) Issu"vig Sta;e Remrd number P mbe�r /y� /��q��7 Leg/a�l Oeu�/np� tion Is �he D�PeNY � Queslion: "����-.JIJW/�i/W•.i �V� l ❑��G�VenY ❑MnwOyasxssedmod'lehome(ICbf.f-� ot �he pm �of�Nea� e�l�sew�e Ure IaM not exree0iny aro (7 ) aoe that unme0iatety wrtourMS ihat struc4na b used W yodwe inmme. EPSCribe Ne �ae and portion Counry Township I hereby certify the above stetements are We, correcl and compiete. slete, aMZlPCOde) Land not exceeding 1(one) acre immediately surrounding residential improvements. Otherland ' Total land (line 1 plus line � ResiCential impmvements or Mnualy �����9 Assessed Mobile I Manufacwred Homa Garsge Other ImprovemerHS ' Total improvemenb (Ilne I fhrougA!!ne � . Total value (!!ne 3 plis Ifne 7) � I hereby certify the above is true, corred, and complete. Vaifying action - Sig�Nra of �cor (�) (2) (3) (<) (5) (6) �8) SlgriaNre af Asseswr Caunry 20 _ pay 20 _ Lesser of 60% of the assessed value o/ the homestead or $45,000 NoMiMstaMUg any aUrer pro�ision. Ne sum olfhe detl�ctiuns pro�ided in IC E7.1-72 b e mo6i7e hortie Naf Is $ not essessed es real property a lo a manufadured hort�e Nat a mt assessed as real pioperry may not erceeA orrehaH (1/JJ af fha astessetl rdfue d Ihe mo6de home ormanuhaWred fm�e. 59naLrte af AWttw Towrahip Datc signeE (monlh. daY. 3Ta�) I D21e s9�ed (monlh. Qay, yea� I �