HomeMy WebLinkAboutHomestead_Head (2)CLAIM FOR HOMESTEAD PROPERTY TAX D M YEAR
CREDIT /STANDARD DEDUCTION �J
` State Form 5073 (RS 17-07)
Prescribed by the Department of Local Government Firence
MAR 2 7 2009
INSTRUCTIONS: See reverse side for filing instructions.
CERTIFicA
I (We) certiT fSA4 �r� m_
1 (We) occupied as our principal place of residence theJbilowing described real property for which a Homestead Property Tax Credit is hereby claimed:
) k I (We) owned ❑ Are buying under contract
Have 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.
CONTRACT • -•
11 buying on contract, Fee Simple owners name
Recorders office where contract is recorded Record number Page
County
PROPERTY
Township Taring district (city, t , township)
Paamel number 1 �
Legal descrption
I he prep7 yn q n:
9 - CV'
Real property ❑ Mobile Home (IC 61.1 -7)
If arty portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that structure is used b produce locortre, describe the use and portion
of the property utilized to produce income.
ASSESSOR USE ONLY
1AS§ESSEDVALUE1
HOMESTEAD
NON-RESIDENTIA
AT100%OFTTV
VALUE
VALUE
Land not exceeding 1 (one) acre immediately
•.;' i v -x +`, - -'
surrounding residential improvements.^.e,'
1
-��y
"
Other land
(2)
-+rti - :49CC
Total land (line 1 plus line 2)
(3)
Residential improvements or Annually
Dwe lling
(4)
Assessed Mobile / Manufactured Home
_�•�•- �,vv�;,�.,c F$c-rx
Garage
(5)
Other improvements
(6)
TWO improvements (fine 4 through fine 6)
(7)
Total value (line 3 plus line 7)
(8)
1 hereby certify the above is true, correct, and
Signature of Assessor
Date signed (north, day, year)
complete.
Verifying action - Signature of mar
Date signed (month, day- year)
STANDARD DEDUCTION
20 _ pay 20 _ 46,000 for 2007 pay 2008 42,000 for 2010 pay 2011
Lesser of 12 gq,000 for 2008 pay 2009 41,000 for 2011 pay 2012
Homestead Valuation $
or 43,000 for 2009 pay 2010 40,000 payable after 2012
Signature Auditor Date signed (month, day, year)
SGT:FORM 53509(R3/&IB) TREASURYS FOAM 13-IA
APPROSTO BY STATE HARM OF ACfOU1T5.MN PRFSCRIBID BY THE OFP.ARTMESI OF GIGSL GOVER\Mavr FINANCE IC 61.1-338.1
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 incentive than ever for homestead fraud.Homestead fraud causes higher tax bills for all;therefore,
. T
benefit 1344-2009 and provide rtgdires taxpayers who receive the anon ece standard allow con to verify that they are eligible or homestead the
benefit and to prm�idc additional identifying information necessary to allow county government to better monimr homestead
filings.This information will be kept confidential and can 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.
JUN 0 2 2011 PART 1: PROPERTY INFORMATION
- Taxpayer Name Location Address
C. N " Head, Ricky
GIBBON COUNTY.AUDITOR 9600 E MAIN ST
° - MACKEY IN 47654_.
8793 .
- IIJ IL1UI1011101111010 llim .11110.110i: ii Kll 10 IRicky Head
9600 E Hwy 168
MACKEY IN 47654 ,
State Parcel Number Legal Description
26-20-14-103-000.097-002 frT SW NW 14-3-9.28 AC
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.
— - 1_-._. — _ ..___—PARTS: 1\PA]�ER INFOR ATION_-- ,__-__.___
Owner I First Middle - _-__- _ _ - Last- -
Wick P teMYi✓& it/E4 D .
Mailing Address(number and street,city,state,and ZIP code) .. EIVS.:me as property address .
9000 r Nov/ /6I . ,UcA'Ey SDA4IA 17176s9
-
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) 0 Same as property address
0
Social Security Number(last 5 digits) Driver's License/State ID Number(last 5 digits) Other(please specify in Part 4 below)
11 I 1 I I I I I State
. 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.
Owner 1 Si Date
Signa Date Telephone
( )l
PART 4: ADDITIONAL INFORIMIA1'ION