HomeMy WebLinkAboutHomestead_Welton //J1�� _ STATE FORM 535M(Nl blot _TRL*SURFAroLM 1S-1A
ry ' ' APPROVED BY STATE BOARD OF ACCOUNTS.NN PRESCRIBED BY TIE DEPARTMET OF LOCALGOVIAAMENT FINANCE IC 6-1.1-224.1
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,
HFA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that:theyam eligible to receive the
• benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will be kept confidential and can only be 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.
MAY 4 ZO11 PART 1: PROPERTY INFORMATION. : . .
— - •Taxpayer Name Location Address
Welton, Paul R '
GIBSON COUNTY AUDITOR 109 Jeremy Lane
Haubstadt IN 47639-8160
' 7517 . - '
Paul R Welton ° II Ili I1.11IIIII 1111111_II-1111I1111111111IF11-111111E11_I1111I11h111III iii --
109 S Jeremy Lane- -
HAUBSTADT IN 47639-8160 - -
IIIL'11IIIIIIIIIIIII" 'IIIIII 1"11191111P1'IIIIIII'1II'I'lIP State Parcel Number Legal Description
26-18-36-403-000.500-009/ WEST HGTS 3RD ADD 309
•
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.
--L--(-- N-- --.--_____----=--- P CJ TA2FAXERUaFOR∎IATION .
O.. .. I — — _
First .Middle . _ __ —
Last
/'A- (IL_ 84/ Ai. Af- � -✓ .
Mailing Address(number and street,city,state,and ZIP code) . - [Satre as property address
105 S • J - - , - • 7A-0/ -ten./ 477‘.3 2 '
Spouse - `� 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 Pan 4 below)
1
.I___11 _l._ .._ , 1 1 state
' " 1 TART 3:cog'-EICATION- e---s—A -
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 Si acute - Date At Telephone
--F6ft-ei Al
f•Signature Date Telephone ( l
( /
PART 4: ADDITION: L INFORMATION
dam^
a CLAIM FOR HOMESTEAD PROPERTY TAX ,
d ° CREDIT /STANDARD DEDUCTION
.e State Form 5473 R2/5-92) -
mT
INSTRUCTIONS: See reverse side for filing instructions.
.. FORM_ YEAR
HC 4 Q
`APR 141995
CERTIFICATION STATEMENT - AA�' ff11�� //�� ((1� �
le) .'�' - certify that on the 15t�aay OPMRch, 9�J
e ) occupied as our principal place of residence the following described real property for which a Homestead Property Tax Credit is hereby claimed:
I (We) own ed ❑ 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. _
CONTRACT RECORDED
If buying on conuact, Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
PROPERTY DESCRIPTION
County
Township -
HOMESTEAD
VALUE
NON - RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
Taxing dist ct (city town, town-p,
p)
Parcel number
Legal description
Other land
It any portion of the residential structure or the land not exceeding one (1) acre 01 immediately surrounds that structure is used to produce income, describe the use and portion
of the property utilized to produce income.
ASSESSOR USE ONLY
TRUE TAX
.VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON - RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Other land
(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)
(6)
I hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
®Ong action - Signature of Auditor
Date signed
19_Pay 19_
Lesser of 1/2 Homestead
Valuation or $2,000
of Auditor
S