HomeMy WebLinkAboutHomestead_Conner (2)CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (R215-92)
ray
INSTRUCTIONS: See reverse side for filing instructions.
FORM ' YEAR
HC10 .
1 ' e) _ k -1 LA 1 7\lV�X A_ certify tha%'n the 1st day of March, 19
) o ed as r principal place residence the following described real property for which a Homestead Properly,., CU1 isjMy claimed:
J I (We) owned ❑ Are buying under contract PIU Y V �D�17
//oi
❑ Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns th a r' buyj)ig.und I ract.
:CONTRACT RECORDED
If buying on contract. Fee Simple owner's name -
Recorder's office where contract is recorded Record number Page
" PROPERTY DESCRIPTI N -
County
Township
Ta 1 is ct fown,'to hip).. '
rce) neSbe�r � M �
Legal description t.
It 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.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
Township
County Township
•eby certify the above statements are true, correct and complete.
Si natur I daimant
ress (number a
veer, a rate. ZIP code)
ASSESSOR USE ONLY
TRUE TAX
.VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON - RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Valuation or 52,000
.
Otherland
(2)
Total land (line 1 plus line 2))
(3)
Residential improvements
Dwelling -
(4)
"
Garage
(5)
-
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 pbs line 7)
(S)
1 hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
®tying action - Signature of Auditor
L
Date signed
STANDARD DEDUCTION ALLOWANCE " -
19 Pay 19_
Lesser of 1/2 Homestead "
S
Valuation or 52,000
Signature of Auditor
Date si ne _ —
Mal E FORM,3 Na 1`+.'1 TRFASURf t EOM(73-1A
APPROVED I A'I PORTANT NOTICE TO HOMESTEADFP PROPERTY ROWNERS II al BY SI ATE BONK°OF NNN ANTS.:NW PAISOTIDED BY Tilt Gibson County Auditor
101 N Main
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 e'er for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
HE1k 1343-2109 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to reecho the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
tilinpt.This information will be kept confidential and can only he accessed by authorized county officials.The Department of
Local Government Finance will use this information to create tests that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Connor, Tyler M/Lori A
102 S Damon
Haubstadt IN 47639
2713
Tyler M/Lori A Connor
102 S Damosa State Parcel Number Legal Description
Haubstadt IN 47639-8159
�t�tt��ttt�t��tttt��t�t�t t�tt�rttt��t�t�t�t�tt t tat tItirllttl 26-1-8--36-403-000.300-009 013-00300-00 WEST HGTS 2ND ADD 102
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.
PART 2: TAXPAYER INFORMATION
Owner I First 'A Middle Last
Add (number Min/2i0 e )co/'
jig.Add (number mid street,city,state,and ZIP code) R'Same as property address
/0 z 5. /Ja.mo3a.Dr 1/Q,AsIa014. SN y 7&39
Spouse First Middle Last
Lori Ann eonnor-
Mailine Address(Number and street,city,state,and ZIP code) ErCarne as property address
/0 2- S. Oa. o,z.Or--. flaa_. 5fazi/7` zN417&o39
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
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