HomeMy WebLinkAboutHomestead_Goodmanis Rxn t CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDIT /STANDARD DEDUCTION HCto
,< State Form 5473(R2/5 -92)
INSTRUCTIONS: See reverse side for tiling instructions
- - — RTI TIONSTATEMENT': '- ..•_•..." ',. -Y t
I (We) certify that on the 1st day of March, 19
We) occupied as our principal place of residence th following described real property for which a Homeste a�` Properly Taz Credit is heretiy claimed:
�
❑ 1 (We) owned ❑ Are buying under contract ,Q��"" ' _ '" 7 s
/J rrac�•
❑ 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.
It buying on contract, Fee Simple owner's name
Recorders office where contract is recorded Record number Page
- PROPERTY DESCRIPTION " 21* ::' e =
Coun /� Township Taxing district (atyyhown townshi
P ✓�EarOcel mber . Legal descriptio � 7
--�' er(1' � / /U a
If any portion of the residential structure or the land not exceeding one (t) sae that immediately sunounds that structure is used to produce income, describe the use and portion
of the property utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES. -
County
Township
County
Township
�,ereby certify the above statements are true, correct and complete.
S na of cl ant
r s (number and street. city, state, ZIP code) -
17 2
- ASSESSOR USE ONLY -
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON - RESIDENTIAL.
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Valuation or $2,000
- -
Other land
(2)
Total land (line I 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 plus line 7)
(g)
1 hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
tying action - Signature of Auditor
.
Date signed
STANDARD DEDUCTION ALLOWANCE" -
19_ Pay 19_
Lesser of 112 Homestead
'
$
Valuation or $2,000
SignaN tlitor
Date si
STATE FORM!!!N12"/HYI TREASURER FORM Tile.
.AFFRovED By war_snow OF.MTTRLTS.bM PRr9SR®m BY fir DEPaneeeTOELL AL GOVELNMFAT Fi:A4'E ICVI.1-1:43
Gibson County Auditor
101 N Main ' IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuate and married couples are limited to one homestead standard deduction.As the receipt of this dedlrtion becomes
more beneficial,there is more incentive than e'er for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
• HEA I344--2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
fiting.s.This information will be kepi confidential and can only he accessed by authorized county officials.The Department of
Local Government Finance will we this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
_ Taxpayer Name Property Address
_ Goodman, Scott A/Valeisha L
RI95-g Q\
Ilazleton IN 47640
66
Scott A/Valeisha L Goodman
2426E Dead Level Rd State Parcel Number Legal Description
Hazleton IN 47640-9273
-- – 26-02-27-100-002.517-017 009-02517-00 PT NW 27 1 10 7.54 AC
"I,I,Ili,pllill,Jaillti iil,itiliiIi,,i IIII,rliliILritifil— - - - - -
3(
PART 2:TAXPAYER 1NFORNIATION
Owner I First Middle Last
S CJ-a- A ,fi1J C,00 D rnA
rf Address(number mid street;city.state,tuul ZIP code) - S'nc property address —- -- , - - - -
2 /2& 6 lSb caact_ g
Spouse First Middle Last
Valeisha 4 yon Coop i'YtA/v
Mailing Address(Number and street,ciy,state,and ZIT'code) [4ame as property address
Zy2 r DEA2) teue_ R n
,
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,h: t she may liable for back taxes and substantial financial penalties.
Owner I Si na j. c Date
PART 4:ADDITIONAL INFORMATION