HomeMy WebLinkAboutHomestead_Piercy USIL FORM 535..:ICI w.l TYFASURFA FORM TilA
.SPPROCED BY<r,TE BOARDOF ACTOU%L5.!IF.Y rtEYRUam BY THE DEPARTMENT OF LOCAL t)WLNMFTT FINANCE a'VI.1-LJ.I
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 lndividuaLs and married couples are limited to one homestead sandani deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than enter for homestead fraud.homestead fraud causes higher tax bills for all:therefore.
inkHEA 1344-2009 requires taxpayers who remise the homestead standard deduction to verify that they are eligible to reecho the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.ibis information will he kept confidential and can only be accessed by authorized county officials.The Depannsent of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Piercy, Leon \I
620 N Gibson w/
Princeton IN 47670
783
Leon Piercy
620 N Gibson State Parcel Number Legal Description
Princeton IN 47670-1726
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PART 2:TAXPAYER INFORMATION
Owner I ' First Middle Last
.ig Address(numb?old stTLY[,city,wits,turn ZIP code) _- __ ... _- — I v! Saute us property oddre�ss—
big N. GA,&.'i �T- & , 2TN it IJ
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Pan 4 below)
sax
- c ...—._. •--,ir- r -%-P�1RT'3:-CEPrFIPICATION-.� -,-}:_.�,�_ � ,. - .,._L
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 Signature Date
,�� CLAIM FOR HOMESTEAD PROPERTY TAX
s; �� CREDIT/STANDARD DEDUCTION
�� State Form 5773 (R2 / 5-92)
m
INSTRUCTIONS: See reverse side for lilrng instructions.
. - • . ?' i ' ' - ,-. . � . �� �-:'�,CERTIFlCATI
FORM YEAR
� �+c�o� - :
�%
�.H.
/
1(We) /�� certi �that on the-1st day. of Ma`rch, 7�9i1
I(We) occupied as our principal place of reside the following described real property for which a Homeste ��Qarry�Tax.Cretlit is herehy_ctaimed:
❑ I(We) owned ❑ Are buying under contract
! Have a beneficial interest in the entity ihat is liable for the property taxes on the property and that owns the property or is buying under a contract.
- . . ,. _ . .. ... . .;. '. . . �_: COHTRACTRECORDED,=..y . .. .,,,: "��.. ��- .. ..£'.:. - ;<�V,z�:.•�.
It Wyirg on comracl, Fee Simple owner's name
Recorder'S ottice where mntract is recorded Recortl number Paqe
Counry Township
P rcel ryun�� �/� ��� Legal tlescription
U
It any portion of ihe residential sVUCture or the land not ezceedi
of Ne D�opertv utilized to produce income_
- .�8 - . ._�aF�:" � ....
Tauing di5trid
��.�C/W 1 ��/ / /—� —
one (i) acre that immediatey surrounds ihat strucmre is used ro produce income, descdbe the use antl portion
: �� ASSESSOR USE ONLY . - TRUE TAX �ASSESSED HOMESTEAD NON-RESIDENiIAL.� ,
, . - VALUE VALUE VALUE .. VALUE_���
Land not exceeding 1(one) acre immediately - - � �
surroundingresidentialimprovements. (�) , '��'
--n
Otherland (Z) � ��
Total land pine 1 plus line Z� (3)
Dwelling (a) .. ., � - '- �
Residential improvements . . ��
Garage (5) . � . ..
Other improvements (6) �
Total improvements (line 4 fhrough line � (7)
7otal value (line 3 p�s line 7� (g)
I hereby certity the above is ime, correct, and Signamre ot nssessor Dace signed
complete.
Verifyirg action - Signature of Auditor Date signed '
19_Pay79_
Lesser of 7/2 Homestead
Vaivation or 52,000
s
signed� _/ ` �7�f
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