HomeMy WebLinkAboutHomestead_Osborn SIDE I OR]I!IK IR f+.W TRF.INREI FORM:}IA
ARRrwEO BY StVE',fluor)/dntNniaw PLr tittsIDaV mtorPAnnwnr IF LOCAL r.o aRNNFRT Ff:vsrE lt'H.1-U-LI
C.bson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to Dive homestead standard deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than ever for homestead fraud.Ilomeslead fraud causes higher tax bills for all:therefore.
HFA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
benefit ant to provide additional identifying information nemsary to allow county government to better monitor homestead
filings.This information will he kept confidential and nn only be accessed by authorized county officials.The Depannlent 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
Osbom, Larry T/ Ethel L
RI Box 72
Hazleton IN 47640
940
try T/Ethel L Osborn
7324 N Frog Pond Rd State Parcel Number Leea1 Description
Hazleton IN 47640-9254
It III III I I I I I I I I I I I I I I I I I I I 26-05-57-077-002.753-017 009-02753-00 PT MD 68(77 1 10 3.50 AC
t o Df r tit a tat f tau t f t n u u f t n u f D-12-C-1
\C.
PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
IARRLI 1A-`12-0 R eaR i✓
g /3Imo�r /' o a�`'fro g iP r ocHi 0
r-4/ SL 7 6 ci
Spouse First Middle Last
!_ouss BoR
Mailing Address(Number and street.cit stale,and ZAP code) f�J..rame as property address
3a'f J✓ Gee° ea,t/ 0 7'oy-D
1 �Rz��ia�, J ✓
1,416 `/!7
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 Sia1'. ////�/
PART 4: ADDITIONAL INFORMATION
alp
aCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
i State Form 5473 (R2I 5-92)
INSTRUCTIONS. See reverse side for filing instructions.
FORM YEAR
HC10
CERTIFICATION STATEMENT
El
R M 4 F4 _ :i
z'
I (We)
-
certify that on the 1 st day of March, 19_
I (We) occupied asIour principa pt a of residence the following described real property for which a Homestead Prvpp>7v Tax Creditaeflereby claimed:
YU i ID�J
❑ 1 (We) owned ❑ A vying under contract
❑ Have a beneficial interest in the entity that is liable for
r,
the property taxes on the property and that owns the-proper y, or istuyyl g under 'co act.
' ,.rnrrnR
CONTRACT RECORDED
It buying on contract, Fee Simple owners name
Recorders office where contract is recorded
Record number
Page
PROPERTY DESCRI ON
County
Township
T g distrlc (city, town
ownship)
Parcel nu _ -7
ca
Legal scrip
( —77
O SO r ' I
I)
It any potion of the residential structure or the land not exceeding one (1) acre that immediately surm nds 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 COUNTRIES
County
Township
County
Township
ig re of claimant
ereby certify the above statements are true, correct
and complete.
Address (number and street, city, state, ZIP code)
ASSESSOR USE ONLY
TRUE TAX
ASSESSED
HOMESTEAD
NON - RESIDENTIAL
VALUE
VALUE
VALUE
VALUE
Land not exceeding 1 (one) acre immediately
(1)
-
surrounding residential improvements.
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 plus line 7)
(8)
I hereby certify the above is true, correct, and
Signature of Assesor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19_ Pay 19
Lesser of 1/2 Homestead
S
Valu tion or S2,000
Signature o Au for
-
Da t si ned
-ISM