HomeMy WebLinkAboutHomestead_LeechCLAIM FOR HOMESTEAD PROPERTY TAX FORM - YEAR
3' CREDIT /STANDARD DEDUCTION HC10
.,� • State Form 5473 (R2 15-92)
e5
INSTRUCTIONS: See reverse side for filing instructions.
F L l
CERTIFICATION STATEMENT . MAY 7 199-
I (We) `i' certify that on the 1st day of March, 19�3
0 e) occupied as ou dncipal place of residence the following described real property for which a Homestead P t T Ckdit Vper
eby.�laimed:
L i I (We) owned ❑ Are buying under contract AUDITOR
WhILHave 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 contract, Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
` PROPERTY DESCRIPTION
County
Towns "p
County
Taxing di rict city, f wn, township)
Parcel number
Legal description
Signature of imant
�1
ate{- !e -w` /--
W9 -Ool�l
(2)
JA.
- -10 181 �
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.
(3)
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
'
County
Township
County
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
Township
reby certify the above statements are true, correct and complete.
®
Signature of imant
�1
ate{- !e -w` /--
Address(numberand street - .state, ZlPcode)
(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
Signature of Auditor
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 pUs line 7)
(6)
I hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
Verifylrg action - Signature of Auditor
Date signed
+� STANDARD DEDUCTION ALLOWANCE
19_Pay 19_
J Lesser of 1/2 Homestead
S
Valuation or $2,000
Signature of Auditor
te signed
DaS-
FAI
I STATE FORM 535690u/84'n) TREASURER FORM TS-IAI
APPROVED BY STATE BOARD OF ACCOUNTS,2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-1.1 22-9.1
IMPORTANT NOTICE TO HOMESTEAD PROPERTY-OWNERS
Individuals and married couples are limited to one homestead standard deduction. As the receipt of this
-auction becomes more beneficial, there is more incentive than ever for homestead fraud. Homestead fraud
,auses higher tax bills for all; therefore, HEA 1344-2099 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 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.
PAR 1: P'OPE' 1' :'FORMATION
Taxpaser Name Pro its Address /I State Parcel Number Legal Description:
Greg/Candace Leech RI Box 160 /// SR V 26-05-22-100-000.151-017 009-00151-00 PT LOC 3 FR 22-1-10
666
1.81 AC C-I
D-12 Complete and return to:
X 1z
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670 _ .
PART 2: TAXPAYER INFORMATION
Owner 1C I O r tl First Middle Last
Mailing Address(nurrim and street city.state a ZIP code) ��
K
1- I la�as Property address
q/// N. S 2 i l 5 ea -le/f a 'L/V
Spouse First Middle Last 5. .dal eldokac
Mailing Address(number and street.city,state and ZIP ZIPP ccode) / ' '�Iy I ///�.
y/// /1/ J ` V CC T 1 v l 1 TA/ me as property address
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
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