HomeMy WebLinkAboutHomestead_Coleman (3)CLAIM FOR HOMESTEAD PROPERTY TAX EAR
>. -- v '� CREDIT /STANDARD DEDUCTION
State Form 5173 (R817 -07) "CL
Prescribed by the Department of Local Government Finance
AUG 1 5 2008
INSTRUCTIONS: See reverse side for riling instructions.
I(We)U A 16lAL2kW(i( ',1� l(II_.511�, l -I PAII <Lx j certiryf91�Sr1 (l4rE%rt��yo�'�r�huzrb_
I (We) occupied as our principal place of residence the follorng%described real property orr which a Homestead Property Tax Credit is/Jhar�elby//palr /ped
I (We) owned ❑ Are buying under contract /Y( 1" -/f/1 1 /
Have a beneficial interest in the entity that is liable for the property taxes the property and that ovens the property or is buyioY / /underraa `contract.
If buying on cconuacl, Fee Simple ovmers name
Recorders office
Toxnship
Record number I Page
Parcel number L I descripti n Is a property i question:
ZAPko Real property ❑ Mobile Home (IC 61.1 -7)
If any portion idential structure or the land not exceeding o ) acre that immediately sunogn� fat re is used to produce income, describe the use and portion
of the props 'zed to produce moo e. C/�l/ (,
a� i�- �6- �'�- 060.���_�9
County
County I Township
I hereby certify the above statements are true, correct and
(number and street, cify, state, and ZIP
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
- •• -i' �- -" ` -`` '^ "�' -_ `'"':
- •- -,,x -fir f "mot
Other land
(2)
Total land (line 1 plus fine 2)
(3)
Residential improvements or Annually
Assessed Mobile I Manufactured Home
Dwelling
(4)
-
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Trial value (fine 3 plus line 7)
(8)
1 hereby certify the above is We, correct. and
complete.
Signature of Assessor
Date signed (month, day, year)
Veritying action - Signature of Auditor
Date signed (month. day. year)
2v pay 20 _ 45,000 for 2007 pay 2008 42,000 for 2010 pay 2011
Lesser of 12 44,000 for 2008 pay 2009 41,000 for 2011 pay 2012
Homestead Valuation $
Of 43,000 for 2009 pay 2010 40,000 payable after 2012
Signature of Auditor Date signed (mci day, year)
STAR 1R4!!'M10./,.n TREASURER PORN(3-IA
♦PPROVED1Y MATEW I°Di VTfl.TS.ZaN PAff(RTFDBY TIE DEPARTW>!rCFUX LGVERNMENTFNA CEIC6-1.112-0..I
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to ox homestead aandard deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than e'er for homestead fraud.Homestead fraud causes higher tax bills for all;therefore.
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to'erify that they are eligible to remise the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.ibis information will he kept cnnlidential and ran only he 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 LNFORMATION
Taxpayer Name Property Address
Coleman, Harold USharon UTammy
Cox
110 S Jeremy LN
Ilaubstadt IN 47639-8160
7329
Harold A Coleman. _ _ -. - -
110 S Jeremy Lane State Parcel Number Legal Description
HAUBSTADT IN 47639-8160
111111111111111111111111111111111111'111111 26-18-36-403-000.101-009 013-00101-00 WEST HGTS 3RD ADD 210
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
/2 aea_
g Address(number and street,city,state,and ZIP code) , I Same as propegv address - — —-
i/D 51 Jeerem Lane ria& t Si) i/7&39
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 Part 4 below)
sow
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 I nahrre / Date
PART 4:ADDITIONAL INFORMATION
nnefmni.11 tafifiaci- sll Aovs
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