HomeMy WebLinkAboutHomestead_LuchiniCLAIM FOR HOMESTEAD PROPERTY TAX FORM
CREDIT /STANDARD DEDUCTION HC10
t State Forth 5473 (R5110-01)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for riling instructions.
YEAR
CERTIFI ATI_ ` STATEMENT%'_'.^' -i',r
I (We) U0 certify that on the let day of March, 20_
I (We) occupied as our principal place residence the following described real property for which a Homestead Property Tart Credit is hereby claimed:
❑ 1 (We) owned ❑ Are buying under contract
Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is buying under a contract.
' c' t' CO _NTRACTRE_COR_DED€S�:,r''"„` If buying buying on contract. Fee Simple owner's name
Recorders office where contract is recorded Record number Pages
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PROP,ERT;YOESCRIPTION -` -� r 3. '"`'''°"'" "` 'xf'.
County
Tovnslup
Testing district (dry, town, township)
Parcel umber
�� oO
L,eQ\aI� description �
Is the property in question:
•
�/r•/rVlr64a♦.YJ
❑ Real property ❑ Mobile Home (I.C. 6.1.1 -7)
If arty portion of the residential structure or the land not exceeding one (1) awe that immediately surrounds that structure is used to produce income, describe cite use and portion
of Ore property ulik m to produce income.
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surrounding residential improvements.
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OTHER "COUNTIES YO{>":'- �,a"ic'
County Township /j
County Township
N RESIDENTWI.. `
'.'VALUE•''
a .
I hereby certify the above statements areYtrue,wfr"eand p[ete`.OF'
^' "
Signature of claimant
' r_1BSO I OTC
^ldress ( umbe d sheet city, ester, ZlP code)
l\
S' " '- >- E U
ASSESSOR'USE ONLY'
TRUE N(
ASS' ' D V"
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HOtdESTEA/.�`..
�'yVALUE'
N RESIDENTWI.. `
'.'VALUE•''
a .
VALUE
%OFTN
Land not exceeding 1 (one) acre immediately
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surrounding residential improvements.
(1)
is
. -' _
Ac'A�.:�,.
Other land
(2)
�=' - -a Rk- _er
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
ra �o
'-�f i ry
�',p. a. r
Residential improvements
E^'°
Garage
(5)
> -�
_ : r-.�.
qi
Other improvements
(6)
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Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(6)
I hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
20 _ Pay 20 _
Lesser of 172 Homestead
Valuation or $6,000 1 $
Signature or Auditor
' • STATE FORM YN(P3/ C) TREtSLRfY FDL
5350 &I N TS-IA
APPROVED BY STATE RQARn OF ACCOUNTS.2009 _ PREWRIBFD BY THE IMPARTMENT OF LOCALCOVERNMENt FINAL IC 6-1.1324.1
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N. Main Street Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
Princeton, IN 47670 more beneficial,there is more incentive than ever 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
(4 benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
FILED fil ngs.The invent Fiinn ce ll be kepi confidential and can only be ace s ed l el ho zed County offi al The mepa trnen[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 • Location Address
APR 0 6 an. ! Luchini, Dean UJeanette L
•
C. .n 409 Bradley DR
Haubstadt IN 47639
299 IBSON COUNTY.AUDITOR •
DeanLLDChini ill IIII:mImi IIDII0illmiIIUillilllimo IIiIII0101111111100110II1101101111
409 Bradley Dr
HAUBSTADT IN 47639-8157
I'IIllllll'Illl'I'lll'11'11'11"1111"'111I'II"1111'1t'IllllII'I State Parcel Number Legal Description .
26-23-06-101-000.668-009 SUNRISE ACRES 2
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.
I PART 2:TAXPAYER INFORNL+,TION
O ._ I First Middle Last
•
hi/4A) L LUCIF/N I,
Mailing Address(number and street,city,state,and ZIP code) Sane as properly address
..
Spouse itst Middle 'Last
JC11-0 T7ti° �- . . Liel/ly / .
-- Maiiing Address(Numberand strceC city,state,arid ZIrcode)`-— ;-"-- -u-Saarne as propertyaddress° _ _.
•
-
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 m. be liable for back taxes and substantial financial penalties. ' .
Own bt ote r