HomeMy WebLinkAboutHomestead_Slayton •r STATE FORM 53'09 1R_/t J't TRFASULER MICA t-tA
EIMPORTANT?NOTICE TO HOMESTEADrP PROPERTY OWNERS z
Gibson County Auditor
101 N Main
PRINCETON IN 47670 Individuals and married couple arc limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial,there is more incenti a than Weer for homestead fraud.h omestead fraud causes higher=tat bills(w all:t erefore.
III - HFA 1341-20119 requires mspaaem who receive the hanesead standard deduction to verity that they eligibe to recebe the
benefit and to provide additional identifying information necessary to allow county eovemment to better monitor homestead
filings.This information will be kept confidential and nut 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.
PART I: PROPERTY INFORMATION
Taxpayer Name Property Address
Slayton, Robyn Lyn
735 G State
Princeton IN 47670
• 922
•
Robyn Lyn Slayton
735 E State State Parcel Number Legal Description
PRINCETON IN 47670-1911
ItIttIIrtrItIIt tIrt tIII 11111 IItttIItr IIt rIr IrtIIrr1 X26-12-07-204-000.993-028 019-00993-o0 NS LOT 3PT R3
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
Ossner I First Middle Last
RaEq�l L7N1 SLAy1 o NI
sg Address(number d street,city,state,and ZIP code) st Same as property address
' 735 E a ST CE S-r. er uAc o r \c4 1-1-7b7o
First Middle Last
Mailing Address(Number and street,city,state.and ZIP code) ❑ Same as property address
Social Security Number(last 5 digits) I Drive's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
Satz
t' 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.
Tarr* L 4 Dat/Ze Z/o
•
R, CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
/ SIa1e Fortn 5473 (R614-03)
Presriibed by the Department of Loca� Govemment Financ_
INSTRUCTIONS: See reverse side lo� /ilinq ins(mclions
�Q'� YEAR
— FORM �
HC10
��' � ' �=1�� �
✓
�
� M�e) cert�ty that on the 7 st day of March, 20
I(We) occupied as our prin al place o( r idence lhe followin escribed real operty (or which a Homestead:Propeity;Ta�c Credil is hereby datmed:
(We) owned ❑ Are buying under contracl /� G��SGt' rn �.�� ��"�' y
�'TC'._!
Have a benefidal interest in the entity that is liable for the property taxes on Ihe property and that owns the property or is buying under a conVaU.
I( buying on conVad, Fee Sunpie ownefs name
Remrdets of6ce where conVacl is recwded
County
Parcel number
To.vnship
Legal description
the
fown,
Record number � Page
O t� ���� � 3.� I �al properry ❑ Mobile Homo (I.C. 61.7-n .
If any portion of Ne resiEentlal sWdure or the land nd exceeding one (1) aae that immediatey surrounds that sW cWre is used lo Droduce incame, describe the use antl portion
of tha property uWized tn produce income.
�"�"� �''� ASSESSOR�USE ON Y'�-'���;3 "=` �TRUETAX'��S AS6ESSED�VALUE HOtdESTEAD eNON-RESI�ENTIAL °� �
'� .��.�' �..'..i:3'-'Y.. �5`.3n°+.����'.'.`�e?� �VALUE�� _AT� OOYe..OF�TTV� � VALUE� ����d�..s-�,.YALUE�.�=.s���
Land not exceeding 1(one) acre immediately _i v'�;... ,. WH''�
(1) C�-.�+ryi''' i�����D-�
suvounding residential improvemenis. '.�, a,,��y��,��<,
Other land ����� ' .
lz) f� , -�
� ��,.,;<.,' ..
Total land (line 1 plus line 2) (g�
4^"t`vb`''�*'i..k i7.�+.4" �,� `f7���
Dwelling (4) T��i�.s����+�
Residentiel improvements orMnualty ,� .
Assessed Modle / Manufactured Home Garage (5) ,� �;,� ~�.;'s`. ,;' s�u�
s
. sa:,�,-x-�' _.d�=z='.�+'
; ��v�,� ��:" ¢, >
Other improvements (6) - --� ���;�,�=
''�-..�' � `�C.__ �
Tdal improvemenLs (line 4 fhrough line 6) (7)
Tdal value (line 3 plis line n (g�
I hereby certify Ihe above is We, corred, and Signawre oi0.ssessor oate signee
complete.
Vrrilying aclion - Signature of Nitlitor Date signed
�.''�"�,.. �.��`�.= �"..�-"`3's 3!�'���.;"�.�`..�5���°�.``s�=STANDARU'�EDUCTION ALLOWANCE�.,?y��".�m`fi. ��%'S�'�''±�"�+'5�:3�e.s��S�`s,�_:t
20 _ Pay 20 _
Lesser of 1/2 HOmestead
vauaUOn w E35.000
5
Signature of Audita " Daple signed
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