HomeMy WebLinkAboutHomestead_Thompson (4)CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
Slate Form 5473 (Re I7 -07)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
I law
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I (We) V /ufl 4 2 �[ /%u certify that eeorrtntyyth 20
(We) occupied as our principal place of residence the following described real property for which a Homestead ProGB !T �
G
I (We) owned ❑ Are buying under contrail
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 •-D r
If txrymg on contract, Fee Simple owners name
Recorders office where contract is recorded Record number Page
County
Township
I hereby certify the above statements are true, correct and complete.
essS(•n7umber
County
of
011 Z.01 re, anO LP codes 1� 4 %)
ASSESSOR USE ONLY
TRUE TAX VALUE
VALUE
HOMESTEAD .
NON-RESIDENTIAL
PROPERTY
1.ASSESSED
County
Township
VALUE
Tmdng distdcl (city, town, township)
Parcel number
Legal escnption
Is the property In question:
surrounding residential improvements.
-
I ❑ Real property ❑ Mobile Home (IC 6- 1.1 -7)
If any portion of the residential structure or the land not exceeding one (1) acre that immechafety su ds that stnutu is used to produce income, describe the use and portion
of the property utilized to produce income. 22
Other land
(2)
County
Township
I hereby certify the above statements are true, correct and complete.
essS(•n7umber
County
of
011 Z.01 re, anO LP codes 1� 4 %)
ASSESSOR USE ONLY
TRUE TAX VALUE
VALUE
HOMESTEAD .
NON-RESIDENTIAL
1.ASSESSED
AT 100% OF TTV
VALUE
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
1 O
- -
Other land
(2)
.•zs'r; :S• `�`%= -..`
Trial land (line 1 plus fine 2)
(3)
Dwelling
(4)
Residential improvements or Annually
Assessed Mobile I Manufactured Home
Garage
(5)
-..
Other improvements
(6)
Total improvements (fine 4 through line 6)
(7)
Total value (line 3 plus fine 7)
(8)
1 hereby certify the above is true, correct, and
Signature of Assessor
Date signed (month, day, year)
complete.
Verifying action - Signature of Auditor
Date signed (month, day. year)
4 pay 20
Lesser of 12
Homestead Valuation
or
45,000 for 2007 pay 2008 42,000 for 2010 pay 2011
44,000 for 2008 pay 2009 41,000 for 2011 pay 2012 $
43,000 for 2009 pay 2010 40,000 payable after 2012
Date signed (month. day. year)
ST ATE FORM 53569(Rite-o9) TREASURER FORM TS-IA I
APPROVED BY STATE BOARD OF ACCOUNTS,2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-I.1 22-8.I
; -°liMA;®R�T� T NO+ TaICEiTiO7 HOlYIlES1TE�AD 7PsR®vP.E�RtT�Yj[O.WiNII SRPTMEM
Individuals and married couples are limited to one homestead standard deduction. As the receipt of this
is.duction becomes more beneficial, there is more incentive than ever for homestead fraud. Homestead fraud
causes higher tax bills for all; therefore, HEA 1344-2009 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 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.
Witer•WIR'i'VY : ..•• . - ,.,-_ PARaTE: PROPERT INF0RMA' iION .' . JO' ti .^"r rgit=r
Taxpayer Name Property Address State Parcel Number Leal Description:
5457E 650 N b`r,1
Travis T Thompson HAZLETON IN 47640 F' I �6 'G4h. 100-003266-017 00 AC 7-1-9 C-I MAT F I-IC
Complete and return to: JUN 3 O 2011 ImII[Ill.M lld13oVImll111nIClloQll'. unaillon
GIBSON COUNTY AUDITOR, 101 N M - IN PRINCETON IN 47670
C. 3- '
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s's 4 ytA;ew F°,I:`-. _ J ' VI''PART2: TeAXRAYFRIN Pltato :10N .... t C . t' 41'n".i:F' --'!'n1V'r1
Owner 1 First • Middle Last
7-
Mating Address(number and street dry,state and ZIP code)
Same as property address
• g-9sT E (so AA g— /V bye
Spouse First Middle Last
Marling Address(number and street,city,state and ZIP code) Same as properly address
Social Secanty Number(last 5 digits) Drivers License State ID Number(last 5 digits) sate Other(please specify in Pan 4 below)
1 - t ; b..nrat 6,. , l'�c, Pr/MT 3:ieEIETIFICATION . , � &Iaa,' zy w u N ,a' .
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 1 Signature Date
Spouse Signature Date Telephone 1
( /
., PARTI3ADDITIONAL INFORMATION :;,∎,!hr.w a2121.4,
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