HomeMy WebLinkAboutHomestead_ColemanCLAIM FOR HOMESTEAD PROPERTY TAX a �F YEAR
CREDIT /STANDARD DEDUCTION H to
State Form 5473 (R614-03)
Prescribed by the Department of Local Government Finance NOV 2 2 2004
INSTRUCTIONS: See reverse side for filing instnrctions.
I (We) Y/ I �L/ cy1%4ggP6}heurlsiday of March, 20
1 (We) 0901pied as our principal place of residencat,
ollowing described real property for which a Homestead Property Tao Credit is hereby claimed:
e) owned ❑ Are buying under w
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.
ONTRACTRECORDED''+- a�':','+ s?}, c '- r£,.''+.�.`.'- 't°,"•-;,ies�,
If buying on contract, Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
.. �'.' .
PROP. Ek-17 O6 NEU' -BY. CLAIMANT IN.OTH ERtOl1NTIESbra?..
County
Township
Taring district city, wn, f0 ip)
Par I number /�5�^/, ��
Legal description
Is the property in question'
— WG�
❑Real property ❑ Mobile Homo (LC. 6-1.1 -7)
If any potion of the residential structure or the W d t exceeding ne (1) sae that immediately surrounds that structure is used to produce income. describe the use and potion
of the property utilized to produce income.
--� 2 /- iCP
a ,e .-2 -
m o ga SI�
.. �'.' .
PROP. Ek-17 O6 NEU' -BY. CLAIMANT IN.OTH ERtOl1NTIESbra?..
County
Township
County Township
I hereby certify the above statements are true, coned and complete.
Sig at of d I [nt
-4ress (number and street, city, state, ZIP code)
ESl RU ONLYh 'K
TRUE TAXY 'LY
ASSESSEDVALUE
HOMESTEAD``z'i"
'- ",VALUE
NON-RESIDENTIAL 4`
5
;100 %'O #TTV
t VALUE A`v f
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
Other land
(2)
OWO
f r Er'
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
''NX'r^rzT'f
�.,� '�• - �-.�.�- a =- 5
MI
Residents] improvements or Annually
Assessed Mobile I Manufactured Home
Garage
(5)'�
.➢.tlJ''r �>�
'{
Other improvements
(6)
,
z�
Trial improvements (line 4 through line 6)
(7)
Total value (line 3 Plus line 7)
(6)
hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
w^s ;•e7i;. 1 rrJ!!'1 ia's. ` ,,,'ice' 3Yr STAN DA RD. DEDUCTION' AL'LOWAHCEz .- :'�,z°,7i- ."c"`,`;`i.
20 _ Pay 20 _
Lesser of 112 Homestead
5
valuation or 835.000
Sigr a ure of Auditor
Date signed
STATE FOFM•3-M I2r)4 41 TSFASLRFA FORM TS-IA
APPROVED BY MATE 6UMoor MtW■T%.:nx PRESCRIBED or TUE OEPM1MEMT OF LOCAL OO'£Ieetnc'T ra:ANCE rc•1.1-r-aa
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to or homestead standard deduction.As the receipt of this deduction becomes
more beneficial.there is more laminae than eser 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 teethe the
benefit and to provide additional identifvinc information necessary to allow county government to better monitor homestead
filings.This information will be kept confidemial and can only he 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.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Coleman, Clinton J/Krista D
RI Box 159
Hazleton IN 47640
183
Clinton J Coleman -
6288 N SR 65 State Parcel Number Legal Description
Hazleton IN 47640
26-05-12-100-000.025-017 009-00025-00 PT LOT 3 FR/2 FR 12 1 10
5.55 AC PT MD 121 1 10.50 AC
-_ _"___-__ - PT MD 122 1 10.25 AC C-1
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 First Middle Last
� � (€ r-L07\
g Address(number and street,city,state,and ZIP code) ❑ Same as property address
(2 �� A' .S GS 14,zle+opt , A.) (77CG/o
Spouse First Middle /� last
Kf lS-�GL DC..L./"TN ( r e Circ.&
Mailing Address(Number and street,city,state,and ZIP code) Same as property address
(26s/K N 5X 65 1-1Az le fp vt ) u y7-yv
"
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 • tore Iatc
PART 4:ADDITIONAL INFORMATION
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