HomeMy WebLinkAboutHomestead_McEllhiney (9) R STATE FORM 5350(N/&10) TAFASL'YFR FORM TStA
APPROVED BY STATE BOARD OFACCOINTS.MS FaESCRImm BY TILE OEP.VRTMEVI OF&CAI.GOVER\MEVT fWAMCE Icou-:u-.1
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS •
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 PILE') beneficial,there is more incentive than ever for homestead fraud Homestead fraud causes higher tax bills for all;Iheiefore,
FA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
41111' , LO 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 homestead fraud.
APR 2 1 2011 PART I: PROPERTY INFORMATION • .
. — C. . Taxpayer Name Location Address
JJJJJJ McEllhiney, Misty D
9I146ON COUNTY AUDITOR, _ 806 E Evans
Princeton IN 47670
948
Misty D McEllhiney X110111.01110111 II 1111111 11011101 OIIDIIiII.IOilOil of 1100110111011 ID II
806 E Evans
PRINCETON IN 47670-2212 ,
ll"IIIIIII' 'IlllllIIllllllrlIllrlllrIltllllilllllttllIl'llllIlI State Parcel Number Legal Description
. 26-12-07-402-002.180-028/LYNCH 2ND 110 PT/111
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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
First Middle - Last
M,S\-y Qa,f., NA MC F. \ \ h; me y
. Mailing Address(number and street.city,state,and ZIP code) 12r Same as property address .
-6 ' F . 1- Ni >US \-• Rrivicea0LI, e N o
Spouse First Middle Last
-"- Mailin Address umbel and street,ci -_ _ __ -, -Ill" _ , -.._____�____ . --g I B 1T1� ry;stain,and7.IP code)—' - � - name ss property address --
Social Security Number(last 5 digits) Drivels License/State ID Number (last 5 digits) Other(please specify in Part 4 below)-
1 1 . I I I I 1 1 _one
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 Date
-
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
` � sta�e Fom, sa�3 (ria r �-o��
Rescnbed by Ihe Departmerri of local Govemment Finance
lNSTRUCTIONS: See reverse side for fi/ing inshuc6ons.
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Gi
��e) yL certify Uial on the 1 st day of March, 20_
I(We) oxupietl as our apal place ot residence the folbwing described real operty fa which a Homestead Property Tac Credit is hereby daimed:
`] I(We) owned ❑ Are buying under contract
L� Have a benefidai interest in the entily ihal is IiaWe fw the propeRy taxes on ihe property and that ams fhe property or is buying under a contraq.
If buyuig om m�VacL Fee Simple ownels tmme
where conlraC is recortled
Recortl number � Page
Caunry Twmship Taringdi&' -y,to�.vn.Iv.mshiPl
Paicel number l description � s ihe property in question:
a, /�d �f ❑ Real property ❑ Mobile Home (IC 6-7.1-n
H airy portion of the residential sVUGUre w Ihe W not exceedirg one (1) acre that immedialely wnountls �hat strucWre is used In pmtluce 4icortre, deuribe Ihe use and port'an
of the pmperty utifimd b Pmdute inmma.
a� -�� -07 - �/od -ooa. ��o - o a-8
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. . .. . .
„..'
Land not exceedirg 1(orre) ave immediatey (�� �"`, � �.., 4:�' _�< .�:� -.��.
surrounding residential improvements.
Other Wnd ' '�`': '• '''- - -
(Z) s_ �.:t:
Tdal Wnd (line 1 plus line 2) (g)
r�>Z�':^i �r' ,�
ResidentialimprovementsaMnualy Dwelling (4) �` � ; .;aa�n``��"-•���'' � -
Assessed Mobiie I ManufaGUred Home x ^�s �:�^ ,� w=. ��
Garage �5� Y r j� �,�.-c,�.c � s'' s�K�_
i. -F S i5'�F'.Y+I. ' Y Y�. .',1'� 2i{. ..
a • -.?� +3 `s,y ':
Ofherimprovements (6) r'r.�r``m x"�;_
_s.- roarv h,_o.y: r.
Tdal improvements (Gne 4 through Grre 6) �7�
Tofal value (line 3 pJ's Grre � �g�
I he2by certity the above is We, cortett, end Sigrmwre ofASSessw Date signed (monfh, day. yea�
comptete.
Vaityirg actian - Sipna4ue af Auditnr Date signed (month. CaY. Y��
� PeY 2� — 45,000 for 2007 pay 2008 42,000 (or 2010 pay 2011
Lesser N 12 qq.000 for 2008 pay 2009 41.000 for 2011 pay 2012
Hwnestead Vaivation S
a 43,000 for 2009 pay 2010 40,000 payable after 2012
SgnaturaofAudtw n �
Date signed (monN. daY• Y��