HomeMy WebLinkAboutHomestead_Miller (5)CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
t Stata Fortn 5473 (R6 / 4-03)
Pres(xibe0 by ihe Department ol Local Govemment Finance
INSTRUCTIONS: See reverse sida for filing insfi/Uions.
�
- . �:3.:-�+n`s ,
FORM `\� YEAR _
HC10
��e) ��� � � certify �hat on the tst day of March, 20_
I(We) occupied a ur principai place of residence lhe ollowing described real prop for which a Homestead Property T�c Credit is hereby daimed:
❑ I(VJe) owned ❑ Are buying under contract �
' Have a benefidal interest in the enlity that is liable for the property taxes on the pmperty and that owns the property or is buying under a conVact.
I( buying on conUact, Fee Simple owners name
Rero�ders alfica where wniract is recwEed
�,+f.'T' °ra -.`..-3�'�„�y4t u:��t'?^:,..-F
s..� :�$.'?is..eT�tC�-.:Y/.�F.3"ZS?"=�ip
CounN ,� Tamship
Tazing district (ciry,
Remrd number � Page
�Parcel number /� Lega'l /des^cri,p't'i7on /� Is the pro rty i question:
�� ��'� ��(/" }^�p / D��p� Q��� �ea� propery ❑ Mob"le Homo (I C 67 7-7)
If any ponion of Ne resitlenlial sWCture or the Wnd not axceeding one (1) aae thal immediatety surtounds Nat swcture is used to produce income, tlewibe ihe use antl portion
of tha property utilized to produce income.
Tavnship
I hereby cer6fy the above statements are W e, correIX and wmplete.
:tlreu (numberaiMsbset, ciry, sfafe, ZlPcode)
^ �442 Eh� Z��ya�J CzecK ESWreS
Coun�y
claimant
��`����A�SSESSOR SE ON Y ti����*�� ��TRUE'TAX�� � ASSESSED VALUE �HOMESTEAD�� `�'a NON'-��RESIDEN�TIAL��z
{ '�+'d6�r.f... _ aia.�_3Y:c6�E4�S'a✓^�.., .f._ r . x�.,�w VALUE-0.� �,....t,: �; :AT 700%OF7N,# +'c.-���VALUEw,�,� ���.s"�.-�`�VALUEFaz:�'a�` [3n�
Land not exceeding 1(ona) acre immedialety --��t, ���_'tc °� ��! r
surrounding residential improvements. �� � �,�$. �`^�.w�'�-�"� � ��,�*r,
Otherland s�"?t�*���"m �
Iz) >Z �w'�:s;�'>-�
Tcfal land (line 1 plus line 2) (3) -
'�' }:,.�gf � 4:-'r�'�vS�i.-.�
� Dwelling (4) �� ���^'. _ � -'nT�s"f , ;�
�Residentiel improvements orMnualty �'��z`'t�����^� ��"^�
Hssessed Mobile / Manufaclured Home Garage (5) � ,� �����i
�w�'�.'x�',»��n�� - �r
�, ti
� �., �. -t . i
Other improvements (5) = �_�' r4..:r"��`:�
,.-
:'3.`�''�;.���
Tdal improvements (line 4 fhrough line 6) (�)
T[tal value (line 3 phs line n (g)
I hereby certify the above is We, torreU, and Signature ofASSessor Date signe0
complete.
Veri(ying action - SynaWre of Putlitor Date syned
20_Pay20_
Lesser of t/2 Homestead
vaivauon w E35.000
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•
Gibsan County Auditor
101 N Main �1
P��N�LJ7� �
APR 2 0 �Utu
mIBSON'O�N��0Ifi6P
3371
llAiElORU!)M�R'l4M1
PFf.Y(FIPmBY I11E
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1RfA54R[AfURV �SIA
InJiviJuaL anJ ma:riN coupl� are limited io ore homc9caJ wndaN J.�uaion. As Ue rmtipi oi Ihi3 dnlunion bcronres
morc beneficial, therc is more incrn;ne than ner (or humc<tea�l ftaud IlomesreaJ frauJ caass hi�her u� 6�ills (or ail: ihere'ae.
HEA 13�f3-?fNM) rcquim uxpa�en �ho rcecive ihc hcxnestraJ sundarJ Aeduction ro reri(y �lu� ihcy are dieiNe io mcenc the
benent ani ro pnn'idr xkliiional identiiyinc infumcnwn nemnrv ro alluw counn� gu.�rmment �u bene' muniror humrsrcaA
lilinps.'Ihix inlormation will he Aryu cantideniinl anA can nNy ln: acm�ud b�� amharirrd cow�ly n0icial�I'I'he Ikpanmem of
I_ucal Gm�cmmem Pinancc w911 u.c �hfs informatiun N cr<att ewls Iha� will help rounty ohFeials climinit< homcstead fiaud.
Joshua J Miller
1447 E Indian Creek Ests
PRINCETON IN 47670-8971
�i�n���u�i��u�n����ni�n�i�i�n�ni�ui��i�n��in���n��
T•rspaver Nnmr
Miller, Joshua Jacob/Melissa N
`ing Address (numbcr wd iVeeL city, smtc, end ZI P codc)
�IN7 � Tndian Cte�� �St.
r� n c e-ti-o n SN
��l �SS0.- � �
�e AdJnss (Numbcr and svicel ci�y, sta�e, and ZII' cuik)
J 7 E. Incl �a^ eteetL ESfi
!' , n C-iv r. Z rJ "7
Stturiry Numhcr (last 5 digits) Drivcrs Liccnu/Staic ID Nwnbcr (la;t 5 digils�
State Parcel Number
26-12-09-100-004.304-027
V
R2 I3ox
1'rincnon I\
INDIAN CREEK PH I
�����`
Snme as pmperty oddms.=.
Oihcr (pleuc speciCy in Part 4 belaw)
('' 11�' �a
� Sumc :ti p`openy adJ�as
Oficr (plcasc cpccify in Part:
III 4 C-1
undersigned certifies, undzr penalty of prrjury•. [hat the abo��e and foregoing infurtnation is we and corrzct and that he or she is eligible to
�e the homeslead standard deduction on this property. Each undersiened also undemands �hat, by claimin¢ additional homestead deductions
-fully, he or she may be liable (or back taxes and substanhal financial penalties. I
I Si awrt Date 7'clephonc
�� ��7,%ii �11�91�n (�