Forms Management - SBS Portals

CLAIM FOR HOMESTEAD PROPERTY TAX
STANDARD / SUPPLEMENTAL DEDUCTION
State Form 5473 (R15 / 5-14)
Prescribed by the Department of Local Government Finance

FORM
HC10

Year

INSTRUCTIONS: Click here for filing instructions.
NOTE: Telephone, Social Security, drivers license, state identification and federal identification numbers are confidential under IC 6-1.1-12-37.

Special Instructions

Reviewed

CERTIFICATION STATEMENT

I (We) First Name

Last Name

certify that I (we) occupied as my (our) principal place of residence or am (are) buying the following described real property under contract for which a Homestead Property Tax Standard Deduction is hereby claimed on the date this application is signed,

Date of Signature (mm-dd-yyyy)

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 property.

CLAIMANT'S INFORMATION

Note: Please provide two identification numbers for each person

Name of Claimant (Legal Name)

Phone

Email

Social Security Number of Claimant (last 5 digits)

Drivers License number of Claimant (last 5 digits)

Issuing
State

Other US issued ID number of Claimant (last 5 digits)

Type of ID

Name of Claimants Spouse (legal name)

Phone

Email (Type NA if not applicable)

Social Security Number of Claimants spouse (last 5 digits)

Drivers License number of Claimant Spouse (last 5 digits)

Issuing
State

Other US issued ID number of Claimant Spouse (last 5 digits)

Type of ID

Contract Recorded

If Buying on Contract, Fee simple Owners Name

Recorders office where contract is recorded

Record number

Page

PROPERTY DESCRIPTION

County

Township (optional)

Taxing district (city, town, township) (optional)

Parcel number (optional)

Legal description (optional)

Property Location Address

Is the property in question:

Real property Annually assessed mobile home (IC 6-1.1-7)

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 utilized to produce income.

PROPERTY OWNED ELSEWHERE BY CLAIMANT

State, County, and Township (enter N/A if not applicable)

Is claimant vacating a homestead?

Address of Claimant

I hereby certify the above statements are true, correct, and complete.

Signature of claimant

Click here to sign

If address of Claimant is different than Property Location Address, please explain.

Address of vacated homestead, if any (number and street, city, state, and ZIP code)

Attach documents if requested by Auditor

DISTRIBUTION: Original - County Auditor, File-Stamped Copy - Taxpayer

Attach Document (PDF, JPG, PNG, GIF, TIFF Only)

Enter the code here

Rush County Auditor

Powered By SBS Portals