HomeMy WebLinkAboutHomestead_Zimmerman SLATE FORM!IV+,R:/1w1 TAF S1ALR TOM(YIA
.ArrR[n'En DT'snit Rn0O0FAM1YENTR.eon PRfANBED BY TILL DEPA1neEYTCitocAL GOVERNMENT FINANCE IC-I.t.r.t.I
Gibson County Auditor
1 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 I dividuaLs and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
/ - more beneficial.there is more incentive than ever for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
HEA 1314-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to recehe 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 he accessed by authorized county officials.The Department of
Local Government Finance will use this information to create tools that will help count'officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
_ Zimmerman, Dolores Gertrude
_ P0Box 1154
Princeton IN 47670
54
Dolores Gertrude Zimmerman
P O Box 166 State Parcel Number Legal Description
FRANCISCO IN 47649-0166
III I I I I I I I I I I I I III 26-12-23-100-000.822-004 002-1x1822-00 PT NW 23-2-10.75 AC
I n tart nr n t u t nt nt nt ru I r D-10
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 _
IOwner I First /^� Middle •IA A Last
aAoRe3 lam! �� a?HAAi
n_g Address(number and street,city,state,and ZIP code) . �_-�❑ Same as property address _— —_
PD. ,fin /lob /lam
Spouse 11 '. First Middle Last
IIIOAl L
Mailing Address(Number and street,city,state,and ZIP axle) �. u Same as property address
Atdti C
Social Security Number(Ian 5 digits) Drivels License/State ID Number (last 5 digits) Other(please specify in Pan 4 below)
5=
' 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 , Da
7
/ I
eE1� °x CLAIM FOR HOMESTEAD PROPERTY TAX FORM
►" a': CREDIT /STANDARD DEDUCTION HC10
State Form 5473 (R215 -92)
INSTRUCTIONS: See reverse side for filing instructions.
CFRTIFICATInm STATFMFNT
YEAR
I (We) -moo XI certif y. th ton tth I td a ?ol Ma* h, 19
occupied as our principal place of residence he ollowing described real property for which a Homestead perty Tax Crredite/hereby claimed:
`"-
�, I (We) owned ❑ Are buying under contract
- - �- -iSCiJ nor.-
El a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is buying"underfat ci.
- CONTRACT RECORDED
It buying on contract, Fee Simple owners name
Recorder's office where contract is recorded Record number Page
` PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
PROPERTY DESCRIPTION -
County
Township
Township
Taxing disMct (city t �, lownship) -
Pam v e,L n o�
Legal esai ,: n
J �'Dr�evn r
It any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that structure is used to produce income, describe the use and portion
of the property utilized to produce income.
` PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
Township
County
Township
eby certify the above statements are true, correct and complete.
' nature of claimant 1
Atldress (numb and street, city, state. ZIPcode)
J �'Dr�evn r
ASSESSOR USE ONLY
-
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON - RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Other land
(2)
Total land (line 1 plus line 2)
(3)
Residential improvements
Dwelling
(4)
- -
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
i
Total value (line 3 plus line 7)
(6)
-
I hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
Verifying action - Signature of Auditor
I Date signed
STANDARD DEDUCTION ALLOWANCE
19 _Pay 19_
Lesser of 1/2 Homestead
/ Valuation or $2,000 r S