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HomeMy WebLinkAboutHomestead_Adcock -. STATE FORM"!!MIR=I YNI IarASURER FORM TSIA Ar?RIT'tD BY STSTE KAMM'MTT/U/S_gH rtrnmmnY THE DEPARTE4r(F LOCAL COELVNR.T FIANCE M.-I.Ir-r.l Gibson County Auditor 101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS PRINCETON IN 47670 Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes more beneficial,there is more incentive than ner for homestead fraud Ilomestead fraud causes higher tax bills for all:therefore. • HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the benefit and to provide additional identifying information nect san'to allow county government to better monitor homestead filings.This information will be kept confidential and©n only le accessed by authori,ed county officials.The Depanment of Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud. f PART 1: PROPERTY INFORMATION Taxpayer Name Property Address Adcock, John T/Lindy M / 913 S Nall X Princeton IN 47670 1398 John T Adcock 913 S Hall St State Parcel Number Legal Description PRINCETON IN 47670-2333 I I Il I II I III I I II II II II II III X26-12-18-101-002.851-028 019-02851-00 PT NW 18-2-10.191 AC t a tat t tf rte fleet t tt rte ea sal a aft This form MUST be returned to County Auditor's office. Please do NOT send this form back with your tax payment to the county treasurer. PART 2:TAXPAYER INFORMATION Owner I First Middle Last I tg Address(number and street.city,state,and ZIP code) ® Same as property address 9I3 Si X10.11 Spouse First Middle Last Mailing Address(Number and street,ciy,state,and ZIP code) f'�l Same as property address Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please'specify in Part 4 below) _ _ .. _ sec — _ _ _ .— _ _ ___ ___ PART 3:CERTIFICATION Each undersigned certifies,under penalty of perjury,that the above and foregoing information is true and correct and that he or she is eligible to receive the homestead standard deduction on this property. Each undersigned also understands that,by claiming additional homestead deductions unlawfully,he or she may be liable for back taxes and substantial financial penalties. Owner I Signature ���� Date • ICLAIM FOR HOMESTEAD PROPERTY TAX CREDiTISTANDARD DEDUCTION � Stete Fum 5473 (R6I4A3) Praxlibed by Ne Departrnant of Locel Govemment Finante INSTRUCTIONS: See revarse side /or tling inshvctions. � (we) �, ;��. ..;� � i ��, i MAY 5 20 I(We) occQpfed as our principai place of residenc'�fh e follovring described real property for which a Homeste��@Ft�iikl��2tiitqg���daimed ❑ I(VJe owned ❑ We buying under cddtract `Have a benefidal interest in lhe enlity that is liable for ihe properry taxes on the pmperty and that owns the property or is buying under a conVaU. 11 buying om m�traq. Fee Simple owners name otfice where wnUaG is remrdetl Tamship (rJry, (own. r i n cer L I escri I Is the v�o� �l�l- Od �� /-rft� y� �� i� -a -. o I1 any poNOn of Ne residenUal sWCture w the Wnd not exceeding ona (1) arre lhat immedia11ety surrounds Nat of the property utilized to produce inwme. '/�/ Q G Counly Twvnship I hereby certify lhe above statements are W e, coned and complete. slafe, 21P County Record number � Paqe question: . Real properry ❑ Mobila Homo ll.C. 61.7-7) ire is used lo produce income, describa the use and portion �'�`^af ���ASSESSORU�SEONLI � �-°�` � "� TRUETAX�.�F ASSESSED�VALUE� �HOMESTEADF � NONAESIUENTIAL�'���� . ��`„-�.a�P.�'��,°`.t_�"i,.'r Yfi'1~a�;e�F.. � -'x :�.;y3����' �:�VALUE.¢,fiYk°�,.� . i4Ttt00Ya OF�TTV VALt1E�? rt. � '.S'�VALUE�'�`l�cb o..,t$ ;ti'�.... . � ' "i� Land not exceeding 1(one) acre immediatety �- i6 �., �'` ' surrounding residential improvementa (�) '.� ��,.�4������'�,�.,.���. �_� r• Other land �Z� :��°�.-�':,N--,� . �. . � 3 ..-�.:.�... - - .a� Total land (line 7 plus line 2) (g� _ 3' J �� .,,__ -.�-�- �� Owellin9 (4) �"� -��L����%��"., s�. . �Residenfial improvemen4s or Mnualty ' ' �'���'-� Assessed Modle / ManufaQUrsd Hame Garage (5) �r�����. � 5 �r'� -. ONer improvements (6) +�--��- � ''�� ¢`}`_ ��7 �+s��'-'� Tatal improvemenis (line 4 through line 6) (7) TUaI value (line 3 pl�s line n (g) I hereby certify Ihe above is We, corred, and Signature otnssessor oate signee complete. Vrrif9ing action - Signature af Autlitor Date signed �z+��"€�si`rr.�:'� `.4'T.'?�^�`4�°''�c`�ti�i�'.'-�-�i`.��.�s`��)� �STANDARD,'DEDUCTION'AL'L'OWANCE;kt���,�,"�,'�.y'n_,�,�".�%��s��',�,w-`1i� `%' .," "`�-�:" .., �.'s�'k? ��`f"��_<.: 20_Pay20_ Lesser W t/2 Homestead vauauon w E35.000 S Sgnature oflwdiiw - Date s'gned