HomeMy WebLinkAboutHomestead_Stafford°' CLAIM FOR HOMESTEAD PROPERTY TAX
x CREDIT/STANDARD DEDUCTION
` !' State Fortn 5673 (R817-07)
Prescnbed by Ihe Deparimerri af Loral Govemment F"viance
INS7RUCTlONS: See rewrse side /orfi(ing insGuctions.
I (We) p( l
I(We) oocupied as our prindpal place of residence fWbwing described real property
� I(We) owned ❑ fve buying under contrad �
,I1 FORM YEAR
'jh�� $K��o
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�i.�ertiry th�at'Aathe i st t March. 20_
Homestead Pro ���'
perty hereby daimed:
GIBSON COUNTY AUDITOR
Have a beneficial interest in the entity that is liable for Me property taxes on ihe property end that owns the property or is buying under a contrad.
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Land not exc�rg 1(orre) acre immediatety ��� ,� " r'.� ti' -`
surtoundingresidentialimprovements. :,.:.,':=_ °;'�':.,..:-'.,r . -
Otherlard (2) : -::�
Tctal WrW Qine 1 plus line 2) �3�
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ResidentialimprovementswMnualy DweIBn9 (4) :Jn�. :..v..,�._,,,...;::�-�r� r:��_=
A55essed Mobile / ManufacWred HOrtre "�c'Y `3�,r �,:: � �
Ga2ge �5� -�,S,�c r���v��. ,�'� �.- � -~
a_ . v. ,_ ..t�...;.-
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O�her improvements is) ��'�`SMW � _.
4b�_ i .1::-SY.:JIe".•�'
Tdal unprovements (fine 4 through Grre 6) �7)
Tcfal velue (line 3 pl'a Grre � (g)
I hereby certiry ihe above is We, cO�red, ard sigrmwre oiwssess« Date signed (monfh, eay, year)
camplete.
Veitying adion - Sigre4ue of �br Date signed (monlA, daY. Y��)
c—b pay 20 _ qs.ppp {ar 2007 pay 2008 42,000 tor 2010 pay 2017
Lesser of 12 qq.000 for 2008 pay 2009 47.000 for 2011
Homestead Valuation paY 2a� Z
� n � 43,000 for 2099 pay 2010 40,000 payable afler 2012
STATE FORM 53:44.11C I S.0.1 TflASUtfl FORM l.-IA
APPROVED BY STATE 02SRp OF MOUNTS.■00 PRr9LAtPm BY TIM DEPARTMC4TOC LOCAL GOVERNMENT FINANCE IC 6-I.I-224.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRI 767 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 eter for homesTead fraud.homestead fraud causes higher tax bills for all:therefore.
HEA 1344-200n requires taxpayers who receive the homestead standard deduction to verify Out they are eligible to receive the
benefit and to provide additional identifying information neasetry to allow county government to better monitor homestead
(1 filinu.This information will he kept confidential and can only he accessed by authorized county officials.The lkpartntent of
JUL2 LUIU Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
as/e/Co Taxpayer Name Property Address
GIBSON COUNTY AUDITOR Moore, Michael L
615 S llall
Princeton IN 47670
954
Christopher D Stafford
615 S Hall St State Parcel Number Legal Description
PRINCETON IN 47670-2327
itirlilllrll'itl itl lillll lltll'II'III III'IItl IIIr IIt ltltt ll111 26-12-07-303-000.026-028/019-00026-00 HALLS 2ND 44 PT
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
Owner I First Middle / / Last
C1'1r / STFpkLir Dauy19S TO{tcru
mg Address(number and street.city,state,and ZIP code) J 'Same as property address
6 I S S J-T q// 5+ /h i Arg'}'of j x/V q
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