HomeMy WebLinkAboutHomestead_Wagner SLATE FORM!Mt.ICf tins TREASURIR mRM TS-IA
.APPROVED BY STSTE!WARD OF Anit.\TS-!nn FRF.4NPEJ)BY Mt DEPARWEITif LOCAL tY)VERNMFNT FINANCE tC 4-l.1-2:-t.I
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47.670 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 net for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
• HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they arc eligible to recehe the
benefit and to provide additional identifying information necesaty to allow county government to better monitor homestead
filings.This information will he kept confidential and can only Iv accessed by authorised county°ficials.The Depanment of
Local Government Finance will use this information to create Roes that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Wagner, Omer C O`6' /
Francisco IN 47639
4511 - - — - -- - - - -- -
Omer C Wagner
PO Box 352 State Parcel Number Legal Description
FRANCISCO IN 47649-0352
11111111111111111 11311110 ll 26-13-19-202-000.077-005 012-00077-00 PERKINS ADD 1
x
Mailing Address(Number and sweet,city,stale,and ZIP code) Same as property address
Social Security Number(last 5 digits) Drivels License/State ID Number (last 5 digits) Other(please spetifv in Pan 4 below)
5es
PART 3:CERTIFICATION •
Each undersigned certifies,under penalty of perjury.that the above and foregoing information is we 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 Data
PART 4: ADDITIONAL INFORMATION
•
0 ^ ; CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (R6 14-03)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instruclinns.
FORM YEAR
HC10
I (We) V certlfyiaatovll a Ist day txurIf Maich, 20
1 (We) occupied as our principal place of residence the following de bed real property for which a Homestead Pr pperty Tax C erC dit &Wglpy claimed:
❑ 1 (We) owned ❑ Are buying under contract r �R 6 204
. Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the propert y or is buying under a contract.
%1r �l iii
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s...: �. a-' r3.' 3ti" r? i`• Y' �`. �- �ss21'. h? 41a�m'_` �r' Emss�• h? .n'3iL`t~CONTRACT_-REC0RDED" - ?" ."^i"
If buying on contract. Fee Simple owners name
Recorders ofioe where contract is recorded Record number Page
:MA'�....'��.�?.
-��" d':+WW=��ROP,ERTY
DESCRIP,TIONiP<.
Coun
Township
Taring district (city, town, township)
Parcel number�^^ ''7
Leg d 'p' n
/
Is the property i question:
-W0 / —
(2)�
Real property ❑ Mobile Homo (LC. 61.1 -7)
If any portion of the residential structure or the land not exceeding one (1) acre that immediacy wmounds that suuctwe is used to produce income, describe the use and portion
of the property utilized to produce income.
0 77- OQJ-
L, i
°•t'4
�vASSESSORrUSE ONLY
County
Township
County Township
I hereby certify the above statements are true. correct and complete.
ignature or daimant
Address (number and street, city, state, ZIP code)
�1
L, i
°•t'4
�vASSESSORrUSE ONLY
4 ,TRUETAX� �-rr
•�VALUE4y5
ASSESSED VALUES
AT 100 %0 . V
HOMESTEAD
VALUE
i O = RESIDENTIAL
h VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
1
()
€- -,'F.. �'4L;E,�✓
1�..'" ,,F n�'•�`t
Otherland
(2)�
`r CA�
Total land (line I plus line 2)
(3)
Dwelling
(4)
Residential improvements or Annually
Assessed Mobile / Manufat]ttred Horne
Garage
(6)
-y;Y 'S.
�i
Other improvements
(6)
*y
Total improvements (line 4 through line 6)
(T)
Total value (line 3 plus line n
(6)
1 hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed