HomeMy WebLinkAboutHomestead_Hyneman STATE FORM!! •IR:/■APO TREMall FORM RIA
IMPORTANT NOTICE TO HOMESTEAD EP PROPERTY ROWNERS` t a „
Gibson County Auditor
101 N Main
PRINCETON IN 47670 Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than eser for homestead fraud.Homestead loud causes higher tat bills for all:therefore.
• HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to revoke 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 official_The D0.panr ent 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
Hyneman, Bert D/Ann M
6394 N SR 65 R4-Drr-146.
Hazleton IN 47640
184
Bert D/Ann M Hyneman
6394 N SR 65 State Parcel Number Leaal Description
Hazleton IN 47640
26-05-12-100-000.161-017 009-00161-00 PT N 12-1-104.347 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 I First Middle Last
•
ger DAY/D Riskin AA)
a Address(number and street,city,state,and ZIP code) e as property address
63W aJ Jt. ,Qt c f/AZZE73,J X,/ Y76V°
Spouse First Middle 11 Last
Mailing Address(Number and sweet,city,state,and ZIP code) Jame as property address
G3 Cc/ N. 51. el dS H4zie r ,u Zz.' 97654
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 I Signature Date
PART 4:ADDITIONAL INFORMATION
•
CLAIM FOR HOMESTEAD PROPERTY TAX FORM
CREDIT /STANDARD DEDUCTION HC10
j, State Form 5473 (R2/ 5 -92)
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INSTRUCTIONS: See reverse side for filing insw0s. —\c6.94 -
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CERTIFICATION STATEMENT
.'e) VJ ..... � ' LArr,,v lyr-v certify that on the 1 st day of March, 1
r tr✓e) occupied as our principal place of residence the (lowing described real property for which a Homestead Property Tax Credit is hereby G
r I (We) owned ❑ Are buying under contract
E3 Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the p ert or bu n n cot
CONTRACT RECORDED - I
I buying on contract, Fee Simple owner's name ,
Recorder's office where contract is recorded eco R rd oulrhO Page
- PROPERTY DESCRIPTION -
County
Township
Taxing d'
trip
'ty, t wn. (own ') •
a
I M
mber
Legal de ,plon
If any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds 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 I Townshi
ASSESSED
areby certify the above statements are In correct and complete.
Sign ure of dai ant
N
Address (number and slreel, city, state. ZIP e) '
k LCz
ASSESSOR USE ONLY
TRUE TAX
ASSESSED
HOMESTEAD
NON - RESIDENTIAL
VALUE
VALUE
VALUE
VALUE
Land not exceeding 1 (one) acre immediately
Date si _ z
_
surrounding residential improvements.
(1)
-
Other land
(2)
Total land (line I plus line 2)
(3)
Dwelling
(4)
Residential improvements
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
-
Total value (line 3 plis line 7)
(S)
1 hereby certify the above is true, correct, and Signature of Assessor
Date signed
,mplete.
®. ing action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19_Pay 19_
Lesser of 1/2 Homestead
S
Valuation or S2,000
Signature of Auditor
Date si _ z
_
V 11