HomeMy WebLinkAboutHomestead_Drake STATE FORM S3560(J/R-la) TREASCRFx FORM 15-1A
APPROVED BY STATE BOARD OF ArrotVFS.200A PRESCRIBED BY THE DEP.ARWET OF LOCAL GOVERNMEYT FINANCE IC 61.1334.1
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N.Main Street Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
Princeton, IN 47670 - more beneficial,there is more incenthe than ever for homestead fraud.Homestead fraud causes higher tax bills for all;therefore, `
HEA 1344-2009 requires taxpayers wiw receive the homestead standard deduction to verify that they are eligible to receive the
F a T T benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will be kept confidential and can onty be accessed by authorized county officials.The Department of
I Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
- PART 1: PROPERTY' INFORMATION
•
NOV 2011 , Taxpayer Name Location Address
C.J.r+ Drake, Marilyn
1655 S 7200 E
GIBSON COUNTY AUDITOR • OAKLAND CITY IN 47660
5691
• Marilyn Drake-- ---- --- IIIIDIII10111111II111111 BIIIIIIDIIQIIIDiI-iI]lII] iI I:III IIIIIIIIIiII]I1II---- -
1855 S 1200 E
Oakland City IN 47660-8113
ItIIltllllllt 111111""I'II'IIIIII'II'III'tJItllItIlIlu y t�lllll State Parcel Number Legal Description
26-14-19-104-000.867-006 CAPT MCCULLOUGH 4PT/5PT '
C-t
.
WI ,
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.
—W -____________ _PA RT.2:_tA PAl'ER_INF4R31ATIOi-- ---------------- — - --
ON..- First Middle Last
•
A1&rilyt'( get e, .. .praKa
Mailing Address(number and street,city.state,and ZIP code) Same as property address
18 55-- S. /too E Octk(4nd e;*Y-T/1 5966d
Mailing Address(Number and street,city,ytate,and ZIP code) ❑ Same as property address
Social Security Number(last 5 digits) I Driver's License/State lD Number (last 5 digits) Other(please specify in Part 4 below)
I I I I I i i I I I -- . -- - 1 Mt - - - -
PART 3: CERTIFICATION
Each undersigned certifies,tinder 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 1 Signature , Date
n
r 4 CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
i State Form 5473 (RS 11"I )
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for riling instructions.
FORM YEAR
HC10
5 — I
I (We) certify that on the 1st day of March, 20
,11((We) occu ed as our pnncipal pla of residence the follovring described real property for which a Homestead Property Tax Credit is hereby claimed:
Fe r (We) owned ❑ Are buying under contract
Wave a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is buying under a contract.
N7RACT!REC0 RDED�¢i`-�.x
If buying on contract, Fee Simple owners name
Recorders office where contract is recorded Record number Page
BYCIAIMANT.IIJ OTHER` COUNTIES'; ��� ,,�- ,?s��:'..tnw3`��y.!!�
County Town-1:
County
Township
7axin d
(' town, to
um r �O
al description
Is the property
c>
Other land
yiinquestion:
�Fteat property E) Mobile Homo (I. C. &1. 1-7)
If any portion of the residential structure or the
land not exceeding one (1) acre that immediately surrounds that structure is used to produce income, describe the use and portion
of the property utilized to produce income.
Trial land (line 1 plus line 2)
(3)
/9- v��a0, ?,/7
BYCIAIMANT.IIJ OTHER` COUNTIES'; ��� ,,�- ,?s��:'..tnw3`��y.!!�
County Town-1:
Township
I hereby certify the above statements are true, correct and complete.
Si tune of claimant
dregs (number and street, city state, ZIP code) ,
ref t�
i�
_>•','x'.— Sc3- n'gs
�ASSESSOR'USE ONLY e - -� Ai
r-` '3sy
'TRUET'ZkM,,.
VALUEu+ -..aAT
ASSESSED.VALUE
100h OF TTV�VALUEc�a`£y�u%?.V/1L.UE
_, _.,
t�,n HOMESTEAD,'
,.f, �-. �y,
.ANON- RESIDENTIAL r+
a_.:.`6
Land not exceeding 1 (one) acre immediately
surrounding residential improvements
(1)
Valuation or $6,000
c>
Other land
2
()
�r WX
: K
Trial land (line 1 plus line 2)
(3)
Residential improvements
Dwelling
(4)
S't`"'� ^� , ,r
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus linen
(g)
I hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
Verifying action - Signature of Auditor
Date signed
».
`= STAN6AR6.DEDUCTION' ALCOWAtICE;";?:;' a, va�is."': m-' �--- t`, .`°_1�`�.`,Lz•'�".�`'#,4;',�.
20_Pay 20_
Lesser of 112 Homestead
TS
Valuation or $6,000
Signature of Auditor
Date signed