HomeMy WebLinkAboutHomestead_PerryCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION =
State Form 5473 (R2/5 -92)'
INSTRUCTIONS: See reverse side for filing instructions.
FORM YEAR
1NHfi � �Q�
- - CERTIFICATION STATEMENT -- -
O ,,44
certify that on-tlie,- p 19
It, occupied as our pri ipal place of resid. _fhe follothe follo described real property for which a Homestead Property Tax CrIT. 45 ereby claimed:
❑ I (We) owned (] Are buying under cdrtRact --
Tave a beneficial interest in the entity that is ,RiHe 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
Recorder's office where contract is recorded Record number Page
-
PROPERTY DESCRIPTION .'-
County
Township
Township
Taxing district (city, t n, township)
Signal of mast
Address (number and street. city, state, ZIP code)
P rc u ruber
Legal description
-0 3S
Total land (line I plus line Z)
It 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
Township
County
Township
nereby certify the above statements are true, correct and complete.
Signal of mast
Address (number and street. city, state, ZIP code)
WIN
ASSESSOR USE ONLY -
TRUE TAX `
VALUE
'ASSESSED
VALUE.
HOMESTEAD
VALUE
NON- RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Other land
(2)
Total land (line I plus line Z)
(3)
Residential improvements
Dwelling
(4)
Garage
(5)
_
- ..
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plis line 7)
(g)
I hereby certify the above is true, correct, and
�nplete.
Signature of Assessor
Date signed
ying action - Signature of Auditor
Date signed
- - : STANDARD DEDUCTION ALLOWANCE
19 _ Pay 19
" Lesser of 1/2 Homestead
Valuation or $2,000 S
signed
• • [TATE FORM n.4 tRr heel TA[ASULLFFORI T3-IA
ArrMSEn BY%TATE atMRD Of-SRA t7S 9.0 PRES(1ntnD BY TIE DEPMTW.YT Or URAL r VER:04 "rP&SCE weft-14.I
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couple are limited to onc homestead standanl deduction.As the receipt of this deduction become
more beneficial,there is more incentive than acr for homestead fraud.Homestead fraud causes higher raw bills for all:therefore.
HEA 1343-3009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to reecho the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will be Lryv confidential and can only he accessed by authorized county officials.The Depanment 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
_ Perry, Billy W/Shon A
6627 N SR 65
Hazleton IN 47640
715
Billy W/Shon A Perry
6627 N SR 65
Hazleton IN 47640 State Parcel Number Legal Description
26-05-01-400-000.635-017 009-00635-00 PT S 1-1-10 4.92 AC
l;
t
I
PART 2:TAXPAYER INFORMATION
Owner< 111 First 1 1 Middle e J Last
Tg aaaiess(numuer acts uee eiry,saw,-and ZDP code) — -- —' • .Same as property address -- --
462'7 Ai i 3 of 65 d547t6,u , i , c 74"
Spouse First Middle Last
Mailing Address(Number and steer,city,state,and ZIP code) ❑ Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
stir
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.
er 1 Signature p Date
• PART 4:ADDITIONAL INFORMATION
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