HomeMy WebLinkAboutHomestead_Wethington (4) STATE FORM 53569(R3/a-10) TREASURER FORM T5.1A
APPROVED BY SPITE BOARD OF ACCOUNTS.2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC61.1-224.1
er IMPORTANT NOTICE TO HOMESTEAD-PROPERTY OWNERS
Individuals and married couples are limited to one homestead standard deduction. As the receipt of this
•
duction becomes more beneficial, there is more incentive than ever for homestead fraud. Homestead 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 necessary to allow county government to better monitor homestead filings. This information
will 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 r.
homestead fraud. vvv
. PA' I: PROPER V INFORMA ION ".-y:--aki,in
Tatpasrer Name Properts Address Slate Parcel Number Leal Description:
Matthew L/J i l l N Wethineton 5857 E 1 1 5 S 26-13-18-300-001.051-004 • PTE SW 18 2 9.9777 AC
FRANCISCO IN 47649 C-1-D-7
Complete and return to: IMIIII111llEMIEIIIIMEICIIIIINE11111rall1111311111
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
' PART 2:TAXPAYER INFORMATION r'-; i•
Owner 1 Forst Middle Last
M Al-41-1e IA) Lee &Jef ti%n9fon
Madi g Address(number and street pty,state and ZIP code)
Same as property address
Spouse First Middle Last
Mailing Address(number and street.city.state and ZIP code) I I Same as property address
Social Security Number(last 5 digits) Driers License/State ID Number(last 5 digits) Stab Other(please specify in Pert 4 below)
4 .,..3,...:...--..1. PnRT_• CER-IFICA:TIQN t. > :., :%.,.. ;k_ a' ..
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 1 Signature Date
"
• FILED
NOV 2 2012
UIUSUN LUUNTY AUD fOR
4/
CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
} CREDIT /STANDARD DEDUCTION 1 HC10
State Form 5473 (R6/4-03) ) r
Prescribed by the Department of Local Government Finance r 7 t
INSTRUCTIONS: See reverse side for filing instructions.
I (We) ceRity that on the 1sCday of March,r20
I (We) occupied as our prin ipal place of residence the following des bed real property for which a Homestead Property Tax Ciedit is hereby daimed:
❑ I (VJe) owned ❑ Are buying under contract � G Svt: C ✓: r, ; 1 �., �.. �.
Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is buying under a contract.
" qtr" c> a'' ria." 3VCONTRIiCTRECORDED3- t£.,,i€uY�•�''.a .'.-.
If buying on contract, Fee Simple owners name
Recorders office where contract is recorded Record number Page
��zexxF.1= - -i 'A>'••f.- yp_ _ e := -_ _ __ _ _ _ _4't!5F'° Y- }'x �:" .
-_ -�
County
Township
Taxing district (nary, town, w ship)
P yrR ^^
U O
L al 'p'
�� ��
Is Ue pmpe i ues6on:
L
S
eal property ❑ Mobile Home (I.C. 6.1.1 -7)
N any portion of the residential structure or the land not exceeding one (1) acre that media ely,surrounds that structure is used to produce income• describe the use and portion
of the property utilized to produce income. 9
fu re
_
wr ASSESSORUSE �N,�
County
Township
County nship
hereby certify the above statements are true, correct and complete.
Sig ture a t
ess (number aM street, dry; state, ZIP code)
# O FP A yJ CI CO kj &
_
wr ASSESSORUSE �N,�
"TRUE TAX* r
_
ASSESSEDVALUE
'HOMESTEAD
�'' "x`VALUEc�
_
Z'" N}2 ON.RESIDENTIAL
+,a� "��gg w
100 %OF1TV
S
Land not exceeding 1 (one) acre immediately
fu re
Ito
surrounding residential improvements.
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Other land
2
Total land (line 1 plus line 2)
(3)
Dwelling
(4)sµt-
Ytyr
._Y,ya -�
Residential Improvements or Annually
Assessed Mobile e / Manufactured Home
Garage
(5)-
3
. __
A,°
n,m
�,. acs,. •c_-
Other improvements
(6)
tt-ti
���,...-+rM
Total improvements (line 4 through line 6)
(T)
Trial value (line 3 pits line n
(6)
1 hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
z .. aevr'.aT
=.._ ? vii°`. a§PY.. •�'`{ .` - sz` i- .`STIWDARD' DEDUCTION' ALLOWANCE- .;;:'?c!'1` �.am�,- :�aT- e.•,9:x�, °.'_ '+,,'�` a.rifi_...�.
20 _ Pay 20 _
Lesser of 112 Homestead
v uation or 535.000
S
Sig
fu re
Ito
Date sig
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