HomeMy WebLinkAboutHomestead_Bradfield (3) scan FOAM?3W+o0.P-16) 117:ASU PIA r0LM IS-IA
.VPRtR ES 91'lAlE MI%Rn OF AI I iI5r\Y.u rgI`CRABIDus lltEOiPAR1.MLTOf LOCLLCOykn%en.T IL 142M F-1,ir-1.1
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERSr-
101 N. Main Street Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
// Princeton, IN 47670 more beneficial.there is more Ms-mist than ever for homestead fraud.Homestead fraud causes higher tax bill:for all:therefore.
I f IIFA 1344-2009 requires taxpayers who remise the homestead standard deduction to'miry that they am eligible to remise the
{...� ,benelh and to provide additional identifying irtiulnahon nycesvn to alhsw count government ;e better rmmior homestead
filiru.This information gill b kept onfidential and an only be a em,sed by audwrized county ol-ticials.T e Depanmert of
Local Government Finance will use this information to create took that will help county officials eliminate homestead fraud.
APR 2 0 2012 PART l:PROPERTY INFORMATION . .
Taxpayer Name Location Address
C. .� - Bradfield, Michael/Roumilda M
840E STATE ST
GIBSON COUNTY AUDITOR PRINCETON IN 47670
993
Michael/ Roumilda M Bradfield 111 1 111 III IIfI 011111131 1 III III 1I01I1 II1 UI U III I1I 11ii Iliul Uih hl
840 E State a
Princeton IN 47670-1914
Dillii illllllltllllllllillllltiltlltlllliililllilllllirillllilili State Parcel Number Legal Description
26-12-08-103-000.552-028 S&R ADO 22 PT
0
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 • F • .
. .,er 1 I First Middle i //� Last
Mailing Address(Number and street.city,state.and ZIP code) U 0 Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) r Other(please specify in Part 4 below)
I I I I I I I I Sur
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 . es r substantial financial penalties. 9
Owner I Signal're /, Date Wa
• . .
rt CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
' CREDIT/STANDARD DEDUCTION HC10
State Fwm 5473 (R6 / 1-03)
Presrribed by l�e Department W Local Govemment Finance
INSTRUCTIONS: See reverse side lor /iling insVUCtions.
I(VJe) � � i " lhat on the 1st day of March, 20_
I(VJ occupied as our principai place of residence Ihe following described real property for w' a Homestea PropeAy Tac Credit is hereby daimed:
I(We) owned ❑ Are buying under contract
Have a beneficial interest in lhe entity that is liable (or ihe property taxes on the property and that owns the property or is buying under a conVaU.
L
If buying om m�uaC, Fee Simple owners name
Counry
.� . � —
if any ponion o
ofthe property
conGad is remrded
,,.��,.�.�,'"`y.gM �:5.�`�-�"u�.�1c`�:..
� 'r- �.14"v
7amship
Legal descripti
lenlial swcWre w the Wnd not axce mg one
� Woduce inwme.
Rewrd number � Page
(ciry, rown,
� Real praperty ❑ MoCtle Homo (I.C. 67.7-n
that sWClure is used b p�oduce income, describe the use and portion
T ^4 --i-.=d P •_ _ .. ._..._ -� _.." ." . "_ _- __ - [ �...1° �"s - '
.�=s��:�.��a,,,�.;..tA�. �...�-n';:;�-.�.�PROP.ERTY�OWNEDIBYCL'41MANT!IN:OTHER'COUNTIESF.r`�„i�?�°'"a'�>.,.���p:�.�;,���,`!^��
Counly Twvnship County Toxnship
I hereby certify the above statements are We, wrrect and complete. Signawre ot claimant
4ddress (numberand sheet, ciry, state, ZlPCOde)
g �pr,�.,�',`�'' ���.r �q.3r.'a.�A�yr.�a:£.; K.� ,L -hr; +.a �s+. . . . - �� � �, y � +..cl:..
�.��,�SSESSOR�USEONLY�'�+��.�r��"`'?s'�'�UETA)C�-�-�v,�-,�SSESSEDVALUE�.HOMESTEAD�.; dNON�tESIOENTL4� n
�.��;t„ ,��+,��,pp,�r;�pR�,.�,,,,�.'y�"�t��*.��v,,�rVALUE•��?y:,AT100%.OF�"TTV��.VALUE�„s'°+�'�i������.,'�V/1LUE,.:3s.au��'.�
Land not exceeding 1(one) acre immedia[ely (') 4'���� c:�{�''Y��;��iF
suROUnding residential improvements. _ .,,,, f� ��� #�:�� �,
Other land (2) i-�,,� j��5. �`yj
. �_�� .�'�S
Tdal land (line 7 plus line 2) (g)
l�r'=+A.^'�.�� c`4�g id�F-.':.
Dwelling (4) ��rF� Y,.,�-�-���7r��.
Residential improvemenfs or Mnuaily ��
0.ssessed Moble / Manufacturad Home Gara e � �:�� ��� s;
9 (5) �'��*�, .�.'�`�yfi��'
"�` �, :�, '�:�' .
Other improvements (6) �-- �.` "'' „�%�
_ <... "_°�bs� s=
Tctal improvements (line 4 through line 6) (7�
Total value (line 3 phs line � (8)
I hereby certify the above is W e, corted, and Signature ofASSeswr Date signed
complete.
Verilying acl'an - Signature otlwdimr Date sgnetl
'.i1- � . er. . s'.?'.: �- � . _ 1".� � _ _ fi't, a ".w... a�«'1- .
•;rx.. r�r��._Y":��d:,ateT -�;s .�"t�,�sr'.'r�"��.'�Y.STANDARU:OEDUCTIONALLOWANCE ,s�,a<d-ux.aa"3�.'4°�zp',`�;`.�3:%s�>��n�''.�'•,4',_`�i'��s�'`'`��:=
20_Pay20_
Lesser W 1f2 Homestead
ValuebOn of 535.000 S
Signature of Auddw � pate signeC