HomeMy WebLinkAboutHomestead_Crecelius (4)°' CLAIM FOR HOMESTEAD PROPERTY TAX
.�- �- �' CREDIT/STANDARD DEDUCTION
State Frnm Sd73 (R8 / 7-07)
•� �su '� Prescnbed by lhe Departmanl o( Local Govemment Finance
(NSTRUCTIONS: See reverse side /or filing instructions.
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� �e) ��!�-� � /. �^A� D_ _. _ . � /J _ D ' . � GIBSON CO yNTY AUDITOR
�(L � f'�fF��'-�" ( h o!'R C.GU/Y certi that on the 1 st da of March, 20_
I(We) occupied as our prinapal place ot residence Ihe f owing described real property for which a Homestead Property Tac Credit is hereby daimed:
�� 1(We) owned ❑ Are buying under contrac[
Have a benefidai interest in the entily Ihat is liable fa the property taxes on the property and that owns the property or is buying under a contrad.
If buying on wnUad, Fee Simpe rnmefs name
Recorders office where coniracl is recortled
Counry
Twmship
(crty,
Recwdnumber �Page
Parcel number l al tlescriplion � Is the ryoperty in queslion:
�M f� .3 I�% /.3 a— I ❑ a�i wocanr ❑ Mow� Fw�„a �ic si. i-n
Ii any portion of the residenUal structure a Iha IaM not exceedirg one (1) acre Ihat immediatey surrounds that strucwra is used b p�oduce income, deuribe Ure use and portion
of Ihe Waperly uUfized �o produce intome.
_adv, �� 6a J'
�o���Y
I hereby ceAify !he above s�atements a2 We, cwrect and compiete.
aMsLeetACity,slafe.andZlPcoCe) ,--� -
Icounry 7i
ign re of daimarri � q�A,G(�('"'
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�rt_ h�-7 � 7 0
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Land not ex�ng 1(orre) acre immediatey (� � .
surtoundirg residentiai improvemenfs.
Other WrW (p� -
Tdal land (line 7 plus line 2) �3)
Dwelling (4) .n?f , w�,� �-4 r, t �' �"'...n
Residential imprwements or Mnually -. a-; , f-._ �-'
Assessed Mobile! ManufacWred Home ` ��+� '
G22gC �5) _ { ✓. �.-.qr .
- .'Y. 'i� `IKf '
Other improvements (6) .
Tctal improvements (line 4 through line 6) �7�
Total value (line 3 p!'s line � �g�
I hereby certify �he above is We, torteU, aMl Signawra ofAssessor Da�e sgned (month, day, year)
wmp�ete.
IVaiying acUon - SignaWre of Fwtlitor Dale signed (�r�mN, day, yea�
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�J _ pay 20 _ 45,000 for 2007 pay 2008 42,000 for 2010 pay 2017
Lesser of 72 qq 000 for 2008 pay 2009 41.000 for 2011 pay 207 2
Homes[ead Valuation $
w 43,000 for 2009 pay 2070 40,000 payable after 2012
SignaWre oflwditor Dale sgned (rtrcnfh, day, year)
STATE FORN 51569 �PJIe-10) TRF.�SUREA FOR\I TS IA
APPROt'FD BY STATE BOARD OF ACCOU�TS, ZOD9 PRESCRIBEU BY THE DEPMTME\T OF LOCAL GO\'ER.\:�¢Yf FIYA\CE IC6I.i-2'-A.I
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Indi��iduals and married couples are limited to one homestead standard deduction. As the receipt of this
r�eduction becomes more beneficial, there is more incenti��e than ever for homestead fraud. Homestead fraud
•causes higher tax bills for all; therefore, HEA 1344-2009 requires taxpayers «�ho receive the homestead
standard deduction to verify that the�� are eligible to receive the benefit and to provide additional identif}�ing
information necessary to allow county government to better monitor homestead filings. This intormation
«�ill be kept confidential and can only be accessed by authorized county officials. The Department of Local
Government Finance will use this information to create tools that will help county officials eliminate
homestead fraud. .
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Taioarer \ame Prooem' Addrm State Parcel Sumber Lecal Dncrintion:
Robert A/ S}•Ivia A Crecelius �ZO� W BROADWAY ST 26-11-12d03-OOOS0.1-028 BMA 31 PT/32
Si PRRJCEfON (N 47670
Cmnplete and relurn to: �III]�IE��17L'J1II��I�[III�I��������0�d0������dm�
GIBSON COUNTY AUDITOR, ]Ol N MAIN PRINCETOY IN 47670
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Owner t Fvat MqEle (ast
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Mailvg ACaress (���/ enC streel aty. s�ate arW 21P coCa) —
� Same as omperty a00reu
/.�sv G✓�ST �,e.e;f-�w� Sr �22,r�«-ho� �4-���0
Social5ecuriry NuMer (lut 5 0ipibl ' Orivefs LicenuJState 10 N�enber (las� 5 Ei9iu) ��e pN¢r (pleasa spet�ty in Pan 4 Eebwl
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�vase F'vsi MWtlle les�
� G. U%!k f� �2cGE Li� a-1'
h1ai1'vg ACCress ( r arq street, ary, state and ZIP mCa) � � Same as oroperty aCdress
Satlal Searfly NumDet �last 5 Elgite) Orivefe LirenaNSUte ID Nianber (last 5 tligits) �° �� (dease scetily in Pen <oelow)
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Each undersigned certifies, under penalty of perjury, that lhe above and foregoing information is true and correcl and thai he or she is eligible to receive the
homestead standard deduction on this property. Each undersigned also understands Ihat, by claiming additional homestead deduction5 unlawfully, he or
she may be liable for back tazes and substantial financial penalties.
Ownert Signature DY.e Ta�eo�ma
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spwse Signa.ve oxe re�eprwie
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GIBSON COUNTY AUDITOR