HomeMy WebLinkAboutHomestead_GullicksonCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (R6 / 4-03)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for riling instructibris.
FORM
YEAR
I (We) (4�1 A V A Pl- 7— N�tMoj V I V-1 2 §ttL�Qftl I ra-roM A -1-V day -o -f ffa e
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I (We) occupied as our pn cipal place of residence the following described real property for which a Homestead PropertViAl C" fM�y claimed:
❑ I (We) owned El Are buying under contract
Save a beneficial interest in the entity that is liable for the property taxes on the property and that owns the propettaJalbu er a contract.
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�OUNT-y I
CONTRACT,-RECOIRDEW;iQ—�'
If buying on contract. F" Simple cr,mar's name
Recorder's office where contract Is recorded Record number page
I IN
#_ USE ONLY
County
Twnship
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I hereby certify the above statements are true, correct and complete. AKW
Township
Taring district (vfyy, to
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Pa untyerp
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at d
In-
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grope
ues on:
property
❑ Mobile Home (I.C. 6-1.1-7)
lf arty portion of the residential stricture or the land not exoAlfing we (1) am that structure is used to produce Income, describe the use and portion
of property utilized to produce income.
I IN
#_ USE ONLY
County
Twnship
cm
Township
I hereby certify the above statements are true, correct and complete. AKW
aijnant
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TRUETAX" x 44�
'ASSESSEDVE61if
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Tt-WOMESTEAd'
}ASSESSOR -'riz
V/LLUE's
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Land not exceeding I (one) acre immediately
surrounding residential Improvements.
9
Other land
(2)
Total land (line I plus line 2)
(3)
Dwelling
(4)
4"
Residential improvements or Annually
Assessed Mobile I Manufactured Home
Garage
Ober improvements
(6)
rf
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(8)
I hereby certify the above is true, correct. and
Signature of Assessor
Data signed
complete.
Verifying action - Signature of Auditor
Date signed
DEDUCTION -AILILOWANCE.
20 _ Pay 20
Lesser of 112 Homestead
S
Valuation or 535,000
e) 14
A
Date sign,-V— A 0
.................... \ ................... I ............................. I ............................................. .
•
nail FORM!l! IE114+1 TITASUI/J1 FORM SIA
.VPRm'En BY sisal.DRAWN'M:I:NTS,:ow PVYWOED BY TIE DEPMENEYT OF L(GL COVERNMENT FINANCE M 6-1I--2.7.4l
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead siandard deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than ern for homestead fratat Homestead fraud causes higher tax bills for all:therefore.
HE.\ 1344-2609 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to recent the
benefit and to provide additional identifying infomumon necessary to allow county government to better monitor homestead
filings.This information will be Lepi confidential and can only he accessed by authorized roomy officials.The Depanmmnt of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
'ART 1: PROPERTY INFORMATION•. - — -
Taxpayer Name Property Address
Gullickson, Kenneth S/Tina L �y
RI (LX/
llaubstadt IN 47639
3159
Kenneth S Gullickson
704E Laurel Ridge Ct State Parcel Number Legal Description
HAUBSTADT IN 47639-8233
1F1nl1nt�F1�uu11L�tlulnlut1t111111 11r1lu n1u1n t111 26-19-31-400-000.764-009 BRIARWOOD II LOT 41 D-9
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 Middle ctic Last
Ong Address(number and street,city,s,tate/,and Z code jSanttai property address cp_
/76t1 biA
Spouse First Middle Last
Mailing Address(Number and street,city',state,and ZIP code) Sa pony address
'o ( ut�G 1oCl
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 gnature �� 'file