HomeMy WebLinkAboutHomestead_Slavik al V E FOAM!kW 12I W•I TREtstuIua rne.4 75-41
APPROVED BY StAlE an1RDOF MCTAVIS.!nx PLESClUnm BY THE DEPARTMENT OF LOCAL rMEINMENT FINANCE IC 6-1.1-174.1
Gibson N Main County Auditor
1001 N IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couple are limited to one homestead sundanl deduction.As the receipt of this deduction becomes
more beneficial,there is mote incentive than ner for homestead fraud.Ilomestead fraud causes higher tat bills for all:therefore.
® HEA l344-2009 requires mspayers 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 he Lepl confidential and can only be accessed by authorized county officials.The D•pannml of
Local Government Finance will use this information to create Owls that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Slavik, Jim UAda L
505 N Ford
Princeton IN 47670
601
Jim L Slavik
505 N Ford State Parcel Number Legal Description
PRINCETON IN 47670-1705
.4(26-12-07-202-003.738-028 019-03738-00 NS LOT 4 PT R2
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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.
Olae a�(r ('p--OWt tt Date
, rt�� � CLAIM FOR HOMESTEAD PROPERTY TAX FORM `n vE
- � CREDIT/STANDARD DEDUCTION Hcio ��� �,
'� � � State Form 5473 (R5 / 16-01 �
Prescribed by the Department of Local Govemment Finance ,
INSTRUCTIONS: See reverse side lor filing instructions.
���'�L'�.'c.�_ �e3 ,',;>d.t r..�� `�:E''T ��•,`-.:-.�;;'`�'=zC R CATION�STAiEMENTFaa . .
�Y �?:a:::�: , ° � f� , ;j=.` \' -
- - - r� - �i 1t li.J JL, �
I(VJe) certify that on the 1st day o( Marc , 0_
I(We) occupied as rincipal place of residence the following described real property for which a Homestead PropertyrTac Cre�it i�QB�by Gaimed:
0 I(We) owned ❑ Are buying under contract
_ /` i7
a benefidal interesl in the entity ihat is liable for ihe property taxes on the property and that owns
f°'3' C L3,:.a��.s,�� Y��- . 3x55'F�3f- =s.i , . . . _. . � � .. .. . w�.
�'; r�A5SES50R 11SE ONLY " `�� s.-�TRUE TAX f- � ASSESSED VALUE HOMESTEAD�,. .� �}NON.RESIUENTIA,L n"��
� .'r+`'..�`'f.�:`.�,'c�'�'�'�s_:-�-R-t�*'J&'v'",4€,��= :4 �i` �;.�;�.�'�-1-VAl.UEi� -�� AT100%OFST7Y..�ocx.%,VALUEf''�.�� r_���c^.��L._VALU.E-.y�.,:•!a� .rt
Land not exceeding i(one) acre immediately �='" "�i,�, �'f�`� ;�'�r+-1���R z* 1
surrounding residential improvemenls. �� � ��� �i?;,,'�"� ���F kJ=''� f" �--�.I
'��_�„�.c,. _...y.�;
Other land �z) '...;�Y}.::t�;;..,y�
.^i, -c#��._..
e
Tdal land (line 7 plus line 2) (g�
z
Dwelling (4) e�.��--a l�"s�'���� ...t
Residential improvements - �^"*��'f {� '�'�� '�-�
Gara e : ����� ��"'�-�y �vr�y' -
9 (5) :� ��S�i.�" �:_.
. �.,.�. . S! r
; �� � '� } .-. - -
Other improvements (6) + ��� �',r t,��';,.�,
- __;,t:,: �,h..
Tdal improvements (line 4 fhrough line 6) (7)
Tdal value (line 3 plus line 7) (g�
1 hereby certify the above is W e, correcl, and Signature ot Assessor Date signed
complete.
Verifying aclion - Signature oflwtlimr Date signed