HomeMy WebLinkAboutHomestead_Pollock (7) STATE FORM'3 sr.ores 3w1 TREASURER FORM TS-IA
.ArrRt En BY STATE BOARD OF MBYENTt_+yr, PREwtIBED BY 711I DEPARTMENT OF LOCALt5wERNMrNT FINANCE ICVI.1-L'4.1
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 incentive than net for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
HEA 1344-2006 requires taxpayers who receive the homestead standard deduction to verify that they arc eligible to scene the
benefit and to provide additional identifying nformauon necessary to allow county go emmem to better monitor homestead
filings.-this information will he kept confidential and can only he accessed by authorized county officials.The Dr-penmen of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead baud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Pollock, Maralu
301 Fourth Avenue
Princeton IN 47670
1479
Maralu Pollock
301 4th Ave State Parcel Number Leoal Description
PRINCETON IN 47670-1020
1111 ���Irt�� 11111,11 26-11-12-101-001.215-028 019-01215-00 TOWER HGTS 153 PT
PART 2:TAXPAYER INFORMATION
Owns 1 First Middle Last
/41 a a PoLI ucK
g Address(number and strut,city,state,and ZIP code) –'– – - — — – Prtame as property address— '— -- - — –- -
S01 p/ 1/– Ave P lnteTo lv f7G70
)
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 Part 4 below)
sae
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
(1
,y ��� � CLAIM FOR HOMESTEAD PROPERTY TAX
i;� '. CREDIT/STANDARD DEDUCTION
�,• State Fortn 5473 (R2 / 5-92)
uo
INSTRUCTIONS: See reverse side (or /iling instructions.
-. . . . � . _. •- . . � _ ' "``:CERTIFlCATI
�.'��
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FORM
HC70
YEAR
S�) � (j—�(_.L�� �'"' i h i n the t st day of March, 19_
I(We) occupied as our principal place of residen ihe follovring described real property for which a Homestead ope ax Credit is hereby daimed:
❑ I(We) owned ❑ Are buying under contract
❑ Have a beneticial interest in the entiry that is liable for the property taxes on ihe pmperty and Ihai owns the property or is buying under a contract.
�' _ • ; .=.. -�-�i:. �.-..CONTRACTRECORDED�;'�...��..... �.a. �.r.� .;. ..iu�-. n� ` �'�;:;_.
If huying on contraci, Fee Simple owner's name
Recordefs oHice where contraci is recordetl Record numDer Page
Counry Tawnship
P cel nu r_� —� Legal descnption ��
1
If any ponion of the residenual swcture or the land noi exceeding one (7) acre t�at
of ihe property utilize0 to protluce inmme.
' P ..�.
s[ructure is usetl to produce'hcome, describe Ne use antl portion
- PROPERTY OWNEO BY CLAIMAM IN OTHER COUNT7ES . �
County Towns�ip Counry TownShip
I hereby certify the above statements are true, correct and complete. Si9na�ure o( Gaimam
Atldress (number and slreet, ury, state, ZIP code)
� � ASSESSOR USE ONLY '. � TRUE TAX ASSESSED HOMESTEAD . NON-RESIDENTIAL. �
�� � , - - . VALUE' VALUE VALUE ' VALUE -� •
Land not exceeding 7(one) acre immediately , . � � �
surrounding residential improvements. (� � � � . �`� � �
Other land (p) � ',�,. `�.' �
Total land (line 1 plus line 2r (3)
Dwelling (4) � � - . - � � �
Residential improvemenis . � . . '
Garage (5) -� '
Other improvements (6) � .
Total improvemenis (line 4 through line � (7)
Total value (line 3 p�s line � (g)
I hereby Certify the above is true, correct, and Signamre of Assessor Date signeC
��iplete.
ryirg ac[ion - Signature ol Auditor Date signed
19_Pay19_
Lesser of ll2 Homestead
Valuation or $2,000
S
_ - - � - �-�� -�
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