HomeMy WebLinkAboutHomestead_Gollnick STAVE FORM!!M Ot:I 41.1 MEASURER FORM 73-IA
"PERMED PT SIAM.PO\PDCK.vTT*STl.9`1 PRESCRIBED BY TIE DEPARTMENT OF LOCAL GOVERNMENT FINANCElc HI-e-LI
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couple.are limited to one homestead sandanl 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 verify that they are eligible to receive the
benefit and to provide additional identifymn information necers ry to allow county government to better monitor homestead
filings.this information will he kept confidential and ran only he accessed by authorized county officials.The Ilepanmem of
Local Goverment Finance will use this information to create ads that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Gollnick, Michael
0
406 F Gibson
Ilaubstadt IN 47639
3125
Michael Gollnick
406E Gibson State Parcel Number Legal Description
HAUBSTADT IN 47639-8204
I t Ill I 11I l 1111111111111111111111111 I I I t l l t l l I I I l t r l I l l III 26-19-31-304-000.056-009 013-00056-00 E PARK ADD 436/437
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 INFOR\NATION
Owner I First Middle Last
/Y7767/9E , S-6-4g C7DL L/V(e&
likg Address(number and street,city,state,and ZIP code) Same as property address
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as property address
Social Security Number(last 5 digits) Drives License/State ID Number oast 5 digits) Other(please specify in Pan 4 below)
_ - - - -- sae —_ - _—
- 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 fir back taxes and substantial financial penalties.
Own.• Igilatin Date
•
PART 4:ADDITIONAL INFORMATION
arR7 7I11U
7770-i /-3• .
UltsboN Cowry AUDITOR
CLAIM FOR HOMESTEAD PROPERTY TAX
_ FORM YEAR
r. - CREDIT /STANDARD DEDUCTION Hcio
State Foam 5473 IRS 17 -07)
•� �.0 Prescribed by the Department at Local Government Finance T{�tiFD F�TAXATION
INSTRUCTIONS: See reverse side for filing instructions. 5 je t f fIn acced23r;ce or nsfer
1 (We) occupied as our principal ace of residence the following described real property for which a Homestead Tax C��eratpA4e'(fq &y
r'T I (We) owned ❑ Are buying under contract Parcel
f1 ✓
i Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns thGIBS ,,0A &ja,ttn}ying,u(!der a contract.
If buying on contract, Fee Simple owner's name
where contract is recorded I Record number I Page
Tavnship
Taxing district
Fa I/y_ umber �( L al descd(�lion Is the �tn-y [i .que wn: '
7 —VOC), � % S--I property ❑ Mobile Home ac e-IJ -7)
If arty portion of the residential stnrcture or the land not exceeding one (1) acre that immediately surrounds that ure is used to produce Income, describe the use and portion
of the property utilized to produce income.
2U— pay 20 — 45,000 for 2007 pay 2008 42,000 for 2010 pay 2011
Lesser of 112 44,000 for 2008 pay 2009 41,000 for 2011 pay 2012
Homestead Valuatiwt 5
w 43,000 for 2009 pay 2010 40,000 payable after 2012
geruml
r
Land not exceeding 1 (one) awe immediately
surrounding residential improvements.
Other land
(2)
Total land (line 1 plus line 2)
(3)
ResidentialimprovementswAnnualy
Dwelling
(q)
-
Assessed Mobile I Manufactured Home
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(8)
1 Hereby certify the above is true, correct, and
Signature ofAssessor
Date signed (month, day, year)
complete.
Verifying action - Signature of Auditor
Date signed (ninth, day. year)
2U— pay 20 — 45,000 for 2007 pay 2008 42,000 for 2010 pay 2011
Lesser of 112 44,000 for 2008 pay 2009 41,000 for 2011 pay 2012
Homestead Valuatiwt 5
w 43,000 for 2009 pay 2010 40,000 payable after 2012