HomeMy WebLinkAboutHomestead_Cleveland (2)CLAIM FOR HOMESTEAD PROPERTY TAX FORM
CREDIT /STANDARD DEDUCTION HC10
Stole Form 5473 (RT / sail
P,escrbed by the Deper4rent of Local Covenwrerd Fa
INSTRUCTIONS: See reverse side for kung instructions.
. .. - . ,•',. CFRTIF7CA STATFJlENT;'
I (we) - certify that on the rat da =f f 20
2 .
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I (We) occupied as our principal place of residence the following described real property for which a Homestead Property T�-x C -�dyt is here med:
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I (We) owned ❑ Am buying under contract GIe$ON1
� Have a beneficial interest in the entity that is liable for the property taxes m the property and that owns the property or islidsdA" 1dV8 i contract
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CONTRACTRECORDmi%'-
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N tuybrg on ombacr, Fee Simple owners name
Legal description
b the Property in question.
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Wees (number and sheaf. dry: state. ZIP code) `1 l .Q �J �o�,c,y_9�
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property ❑ Mobile Hone (W. 61.1 -7)
N arty portion of the rewdent al sbucaae or the land riot exceeding one (1) acre that inmedaldy sunaadds dud sd&Am is used to produce 6xnrne, describe the use and portion
of Me property ubf®d to pmdrca �.
Pacmde/s office where muted is recorded
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Reoord number
Page
. PROPERTY OESCRIP.TIONr
Cor+rty
TowmNo
Tang d. (dy, town. t . )
Parcel narba
Legal description
b the Property in question.
(��ure
Wees (number and sheaf. dry: state. ZIP code) `1 l .Q �J �o�,c,y_9�
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rs_.H
property ❑ Mobile Hone (W. 61.1 -7)
N arty portion of the rewdent al sbucaae or the land riot exceeding one (1) acre that inmedaldy sunaadds dud sd&Am is used to produce 6xnrne, describe the use and portion
of Me property ubf®d to pmdrca �.
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I . - -- _...:r ,. '':.--:: PROPatNOMIMBl ::cLADIMTIN'i)THERCOIRIiMSti ±.
County
Township
County
Township
1 hereby certify the above stalimmts are true, correct and complete.
of daunart
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Wees (number and sheaf. dry: state. ZIP code) `1 l .Q �J �o�,c,y_9�
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TEAD.
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ASSESSOR USE ONLY A
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Land not exceeding 1 (are) acre irmodiatey
srarwmd'ag residential improvements.
Other land
(2)
Tdal land (fare 1 plus fife 2)
(3)
Dwelling
(4)
Residential mprovements or Annually
Assessed Mobile I M mudac to eJ Home
Garage
.A
Other improvements
(6)
},
Trial improvements (fare 4 through fine b)
(T)
Tcfal value (fare 3 plrs line 7)
(8)
1 hereby certify the above rs true, cared, and
complete-
signature of Astor
Date silted
Vaifyirg action - Signebae of Auditor
DaOe signed
STMDARD DEDUCTIOR'ALLOWMCE
20 _ Pay 20
Lesser of 12 Homestead
Valuation or 535.000
$
Si%atore of &XUW
Data signed
SIArL FORM!rw,Ru YPI - 11,.-SUM FORM TS-IA
crrsovas BY sr.re IXARDOF y[IIsrsa.w PtISRlnm BY THE orPAkn4rl4 LOCAL r \aVMmml FuaserW t.t x..1.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 IndividuaLs and married couple.are limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than e\er for homestead fraud.Homestead fraud causes higher tat bills for all:therefore.
• HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to reeehe the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will he kept confidential and can only be accessed by authorized comity officials.The tkpanm ent 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
Cleveland, Scena
505 S 8TH AVE
Ilaubstadt IN 47639
1173 -
Scena Cleveland
505 S 8th Ave State Parcel Number LeEal Description
HAUBSTADT IN 47639-8237
II III II I I I I I I III III ' I II ' 26-23-06-200-000.772-009 ALTS DEUTSCHE STADT 6PT UNIT 1
to urF stn t t nunF t o tut stn F n n
Sc
PART 2:TAXPAYER INFORMATION
Owner 1 e /3 Firs[ -rig Middle Ci eVe / / Last
_ SG E h/ � `_YI
•tg Address(number and street,city,stab,and LIP code - 7�_ — .- .2 Same as property address_ —. — _ -_
sv5� F AS'''.
��l
Spouse First Middle Last
Mailing Address(Number and street,city,state.and ZIP code) [] 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)
Sum
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 eliuible 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 Si tore Date
0