HomeMy WebLinkAboutHomestead_AdamsCLAIM FOR HOMESTEAD PROPERTY TAX FORM vEAR
CREDIT /STANDARD DEDUCTION HC10
` Slate Form 5473 (Re I rime
Prescribed by the Department of Local Government Finance
INSTRUCTIONS. See reverse side for filing instructions.
CERTIFICATIOWSTATEMENT
I (We) certify that on the 1 st day of March, 20
1 (We) occupied as our principal place of residence the following described real property for which a Homestead T+rSp a ,dit is hereby claimed:
I (We) owned ❑ Are buying under contract GIBSON COUNTY AUDITOR
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 •-s r
If buying on contract Fee Simple owners name
Recorders office where contract is recorded Record number Page
County I Tc mship I Taxing district (city, town, township)
/'�(� // `e_gall OWCnnp on Is the property in question:
E,U �L9 S II0 1 ❑ Real property ❑ Mobile Home (IC 61.1 -71
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.
ASSESSOlk
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
Other land
(2)
Tdal land (line 1 plus line 2)
(3)
Residential improvements or Annually
Dwelling
(4)
Assessed Mobile I Manufactured Horne•,..
-
Garage
(5)
-
Other improvements
(6)
Total improvements (line 4 through Gne 6)
(7)
Total value (line 3 plus fine 7)
(8)
1 hereby Certify the above is We, correct, and
Signature of Assessor
Date signed (month, day, year)
complete.
Verifying action - Sgruture of Auditor
Date sign ad (month, day. year)
2u_ pay 20_
Lesser of 12
Homestead Valuation
Of
45,000 for 2007 pay 2008 42,000 for 2010 pay 2011
44,000 for 2008 pay 2009 41,000 for 2011 pay 2012
43,000 for 2009 pay 2010 40,000 payable after 2012
Signature of Auditor ( �� I / I Date (O ed' 0 th.0y, year)
5EVE E(MM5It (RN E-p) TRFAauummA FORM i-IA
.ArmRIT'ED BY STATE BOARD Of Afri o.TS.A,n PRr!(1JBED BY TIn DEPARTMENTO FLDEAt IXNrR.VMrAT FINANCE IC L I.I-L-1.I
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 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 ever for homestead fraud.Homestead fraud causes higher tat bills for all;therefore.
-. HEA l 344-2009 requires taxpayers who receive the homestead standard deduction to verify that they arc eligible to mceise the
benefit and to provide additional identifying. information necessary to allow county government to better monitor homestead
filings.This infornution will he kepi conhdeauial 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.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Adams, E C
HI Q\
tlaubstadt IN 47639
8314
E C Adams
702E Haub St State Parcel Number Legal Description
HAUBSTADT IN 47639-8234
I t1rr11rrr 1r11rrrr11r1tlr tlrrlr rrItIarIIrt t
�r IIIrr rr r1t1rr 1r11 26-19-31-400-000.765-009 BRIARWOOD II LOT 32 D-9
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
-—1 tg Address(number and street,city.state,and ZIP code) - - - - - Same ac pmperry oddres-- - -- -" -- --
02 ,e sT / A1R 'Sr JIA2uBST-619,6Y Y ) 1-1939
First Middle Last
Mailing Address(Number and SlreeL city,state,and ZIP code) u Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Pan 4 below)
Soo
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 I Signature Date
PART 4:ADDITIONAL INFORMATION
•