HomeMy WebLinkAboutHomestead_Gomez STATE FORM.J.( ,A`,W„ naszeA FOAM StA
APPRYW'ED BY CIAtt BOxRDOFMTTRINTs.Tn PR[3AI13moY MME DrrARrxO•:MECr LOCAL CAVEAMMrTT R:A'CE M 6-1.1-1'-1.1
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 incentnr than ever for homestead fraud homestead fraud causes higher tax bills for all:therefore.
• HEA 1344-200 requires taxpayers who receive the homestead standard deduction to verify that they am eligible to receive the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
tiling::.This information will be kept confdemial and can only be accessed by authorized county officials.The Department of
Local Government Finance will the this information to create tools that will help county officials eliminate homestead fraud.
. PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Gomez, Kimberly
— EOHlO
PRINCETON IN 47670— _ _ _ _
1374
Kimberly Gomez
914 E Ohio St State Parcel Number Leal Description
PRINCETON IN 47670-3065
I II III I III II II II I I III II II 26-12-17-103-004.248-028 SOUTH PARK SUBDIVISION 15
r at set r at ur r nn nt t nn r n nt
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 1 _ \- Middle Last
lM LlF A.1.`( '
Q . 1,. Yv1 vt -e.Z
ig Address(mum and street,city,state,and ZIP code) )4 Same as property address
Spouse irst� Middle Last
Mailing Address(Number and street,city,state.and ZIP code) 0 Same as property address
Social Security Number(last 5 digits) I Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
sox
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
ISSignature Date
•
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
Stata Fpm 5473 (R6I4-03)
Prescribed by Ne Departmen� ot Locel Govemmmt Finance
INSTRUCTIONS: See ieverse sida )or filrng insh�tGOns.
FO�RCM � YEAR
�H�pO
N �
� .��
APR 2 6 2006
��e) � certiry that o��vsf d�ot;�March, 20
I(We) occupied as our principal place of residence the following scn ed real property for i a Homestead0.�k3peii}7 f�i�'re�iYisgieieb�aimed:
�(We) owned ❑ Fve buying under contract
, Have a benefidal interest in Ne entity that is liable for the pmperty taxes on Ihe property and that owns the property or is buying under a wntraU.
If buying on conVad, Fee Simple owners name
RecoNers oifica where contract is recorEed
Counry
Tw�nship
(cify, fown, fownship)
Rewrd number � Page
Parcel num6er L al descriptio/n [ �/�/ Is the properry in question:
o � 9-o ya 5`S- � p� 7�/� /A C���//�(� �� D�opery ❑ Mobile Homo (I C 67 7 7)
H any poNm of Ihe rasitlential sW cture w Ne land not exceeding one (1) aae Nat immedialely wrtounds that swaura is used b produce income. describe Ne use and poNon
ot Ihe property uL7¢e0 b produce i�ome. �S
CouNy
I hereby certify the above statemenls are true, corted and complele.
Addreu (num6er e� strref, ciry; s(afe, ZIP cade)
Couniy
s
% � .
Toxnship
�3' 'x '�1Si'S ° Y:R'eE,Ye: '" igt7`a*—'l'� .f , � n,� ..� ,y, ' : -Ty. 4 . . � ..�.
- . . �-,9_0.. r�x�..,z�:Ai .. .. vTrt; .'in:o T3 `,�..�..:ST/WDARD:DEOUCTION�ALLOWANCE�.n:�'�`.i�aG.ix�� .�'-'�"Ett�1e€��rs4.i�.�`�� rK
. 20_Pay20_
Lesser of 1/2 Homestead
vaivanon w E35.000
S
SgnaWra oflwdilw ' Date signed