HomeMy WebLinkAboutHomestead_Osborne (3)t CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
Sute Form 5473 (R6I4-03)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing insuuchons.
OCT ;) 4 2003
I (we) certiy tGiednAeL'
I (We) occupied as our pdncipal place o residence the fol 'ng described real property for which a Hom ead Property Tat
`--F' (We) owned ❑ Are buying under contract
i�
Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is buying under a cenuact.
--- ' CONT_RAC_T.!RE_CORDED,,`tI'"kef: ': -` ;:• � `. .t�.'�' -'=Y,
If buying on contract, Fee Simple ownees name
Recorder's office where contract is recorded Record number Page
ASSESSOR�USE ON' Y
County Township
Taxing district (city, town, township)
Parcel number Legal s
n
Is the property in question:
0I
Address (number and street, city, state, ZIP coder-060'x- %/y'
al propeM ❑ Mobile Home (M 6.1.1-7)
If any portion of the residentlal structure or the Land not exceeding one (1) acre that immediately surrounds that suu re is used to produce income, describe the use and portion
of the property utilized to produce income.
dG -/3 -/9- - 6c -
ASSESSOR�USE ON' Y
County Township
County Township
I hereby certify the above statements are true, correct and complete.
Si nature or claimant
R'
Address (number and street, city, state, ZIP coder-060'x- %/y'
/oQ u, Q/¢STN"7 rA4r-4:; SCo Srt,t Y'76 579
ASSESSOR�USE ON' Y
-TRUE TAX
ASSESSED VALUE
°
eHOMEST EAD *
3 NON;RESIDENTIAI
ATY00 /y,OFTTV
VAL'UE�y
i gEE
Land not exceeding 1 (one) acre immediately
(1)
s'
surrounding residential improvements.
��aaF{{'x„r'�yc•; �'"#".
Other land
(2)
Total land (line 1 plus line 2)
(3)
Dwelling
(4)�.%i4Z'w
Residential Improvements or Annualty
Assessed Mobile I Manufactured Home
Garage
(6)
Other improvements
(6)
,rhfa
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(6)
1 hereby certify the above Is We, correct, and
Signature of Assessor
Date signed
oomplele.
Verifying action - Signature of Auditor
Date signed
>=.i' - "`- STAN , :0eoucnoN nL[owI1NCE?!?
20 Pay 20_
Lesser of If2 Homestead
Vaua9on or 535.000 3
Signature of Au6t Date signed
STATE FORM 535!9(53/&10) TRFASL'FFll FORM TS-1A
APPROVED BY STATE BOARD OF ACCOUNTS.UA PRESCRIBW BYTtE DEPARME'a OF LOCAL GOVERNMENT FMA`10E IC 611-322.1
Gilson 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 more beneficial,there is more incentive than ever for homestead fraud.Homestead fraud causes higher tax bills for all;therefore,
ti FILED HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive 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 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 5 2011 - PART l: PROPERTY INFORMATION -
�� Taxpayer Name Location Address
C'd'r V Osborne, Ricky UDianna M
GIBSON COUNTY AUDITOR 108 W Chestnut
Francisco IN 47649
.94
Ricky .Osborne ') IIII[IIIIQIIIIIIII_I IIId111llIIt IOii.111 IlQlf__II_IIIIIDIIIIIIC011111:iiiI1III•
HAUBSTADT IN 47639-00•• -
•
'ilil'il'iii'i1ili1I1iil0i"i'I11I ' ' IIIlllilIIIlll'I'ii State Parcel Number Legal Description
_ — ' 26-13-19-202-000.293-005 /OLD PLAN 62 ' -
5
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
CR icel - _ ° L.-ee dSd6rAe
Mailing Address(number and s city.state,and ZIP code) 9-Same as property address
PO &-y 4q log Ches./A(6T
Spouse First Middle 6o/il� o Last
Mailing Address(Numbei and street,city,state,and ZIP code) ' _ , - - lifSa c as property address. . - --
0
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
0