Homestead_Thomas41
" CLAIM FOR HOMESTEAD PROPERTY TAX
i 4 STANDARD / SUPPLEMENTAL DEDUCTION
State Form 5473 (R1216-09)
ra ✓� Prescribed by the Department of Loral Govemmenl Finance
INSTRUCTIONS: See reverse side for filing instructions.
FEB :- 2 2010
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CERTIFICATION STATEMENT
I (We) certify that I (RwRe)rr11o�t,culwrr��rri���� ��f�a11sfyqyp(/�(JJuQ�t� pal
place of residence or am (are) buying the following d real property for which a Homestead Property Tax R11Veld'D�UdiUhTiS heeby dammed
lo�beAd
under ct on the date this application is filed, 2/ U 1 (date of filing):
I (We) own ❑ Am (are) buying under recorded contract
p Am (are) entitled to occupy as a tenant - stockholder of a cooperative housing corporation
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified personal residence trust
INFORMATION
If buying an contract Fee Simple owners name
Recorders office where contract is recorded Record number Page
PROPERTY
County
Township
Taxing district (cif}; town, township)
a umber
Legal description
Is the property in question:
O❑
Real property ❑ Annually assessed mobile home (IC 6-1.1 -7)
tt any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that strucNre is used to produce income, describe the use and portion
�f the property utilized to produce income. I .
W 4 I • • OW I 4 • ! ' 4C A 19
PROPERTY • • OTHER COUNTIES
County Township County Township
I hereby certify the above statements are true, correct and complete.
Sig of claimant
Addi m 1 n�sueet, - ,state, and ZlPcode) lr Fr • _Z/� y %
e�C1 J
Co
ASSESSOR USE ONLY TRUE TAX VALUE ASSESSED VALUE I HOMESTEAD NON-RESIDENTIAL
AT 100% OF TTV I VALUE VALUE
Land not exceeding 1 (one) acre immediately
surrbuntin residential improvements. (1) 2S_% =.ate' +- - -'•3r c''.SY' �,;.:r«
Other land
(2)
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
Residential improvements or Annually
- • - -
-°^
Assessed Mobile I Manufactured Home
Garage
5
car,. 4;3r 'G r '� '' 4 •` `s %''
Other improvements
(6)
r
Total Improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(8)
I hereby certify the above is true, correct.
Signature of Assessor
Date signed (month, day, year)
and complete.
Verifying action - Signature of Auditor
Date signed (month, day, year)
STANDARD DEDUCTION ALLOWANCE
20 _ pay 20 _ Lesser of 60% of the assessed value of the homestead or $45,000
Netuithslandi g any other provision, the sum of the deductions provided in IC 6-1.1 -12 to a mobile home that is
$
-
not assessed as reel property or to a manufactured home that is rot assessed as reel property may not exceed
one-half (1/2) of the assessed value of the mob2e home or manufactured home.
Signatum of Audilar
<
Date ( day, yeah
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STATE FORM 5156(P3 1610) TREASURFA FORM TS-IA
' APPRONTD BY STATE BOARD OF ACCOUNTS,IlN PRESCRIBED BY TIE DEPARTMENT OF LOCALCOYLA%MENT FINANCE IC 61.1-224.1
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N. Main Street. Individuals and manied 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,
FILED HEA 1344-2009 requires ditioners who receive the homestead standard deduction to verify that they are eligible to homes:the
�® benefit and to proide additional idalt co ing 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 othcials-The Department of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
JUN 21 2011 PART 1: PROPERTY INFORMATION .
Taxpayer Name Location Address
c . - . . Thomas, Darrin M/Kelly
GIBSON COUNTY AUDITOR zrz s CENTER ST
FRANCISCO IN 47649
1521
III II mom_ IIL101IL111ul II]1111_IIIJ10lFtiii IDarrinMThomas
212 S Center
FRANCISCO IN 47649
State Parcel Number / Legal Description .
26-13-20-103-000.059-00$ /w&M ADD 7 M 8-C ADD 18 —
-
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.
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• PART 2: TAXPAYER IrNFORMATION. . •
:1D4IC RT N - First 11 G4-4 e / Middle �A,Q /Yl ns Last
Mailing Address(number and sweet,city,state,and ZIP code) /r( C/ ame as property address
SpolIu/se First Middle - Last
el aue. F
Miilin'g A (Numbei and street,city:state,andZJP crock) -Same as property address - - _ —
��� `--
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.properry.'Each undersigned also understands that,by claiming additional homestead deductions
unlawfully,he or she may be liable for back taxes and substantial financial penalties.
e1-1 Signature �/ Date
'