HomeMy WebLinkAboutHomestead_Conradd% x�
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CLAIM FOR HOMESTEAD PROPERTY TAX
Township
CREDIT /STANDARD DEDUCTION
Township
aeby certify the above statements are true, correct and complete.
uu
State Form 5473 (R2 / 5 -92)
Legal description C.
INSTRUCTIONS: See reverse side for filino instructions.
FORM YEAR
p
APR 14,
_ CERTIFIC ON STATEMENT I `
I (We) n - av cenif �tapl, n»l�ff �y_ J,tarcl(�¢.1g�
#'e) occupied as our principal place of es ence the following described real property for which a Homeste r nyt7a> - redtt "is heieby-dair ied:
I (We) owned ❑ Are buying under contract
❑ 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 RECORDED-, -
It buying on contract, Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
4. .
PROPERTY DESCRIPTION
Cou ..
Township
County
Township
aeby certify the above statements are true, correct and complete.
Si atur t claimant
Parcel n berr-�
Legal description C.
-yam
Other land
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
aeby certify the above statements are true, correct and complete.
Si atur t claimant
Address (number and street, city. state. ZIP code)
�C cs1 Noy KI 14-7LPL10
- 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 S2,0D0
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 plus line i)
(6)
I hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
Verifying action - Signature of Auditor
fib
Date signed
I
STANDARD DEDUCTION ALLOWANCE -
19_ Pay 19_
-
Lesser of 1/2 Homestead
S
Valuation or S2,0D0
Signature of Auditor
Date signed
1
STATE FORM 53569(R3r8-10) TREASURER FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS,2009., PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-1.1=2-8.1
I - IMP ;4 AN NO O. :110 HOMES FAD "-OP :4' Y OWN +'•S
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 ever for homestead fraud. Homestead fraud
'cruses higher tax bills for all; therefore, HEA 1344-2009 requires taxpayers who receive the homestead
stt ndard 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.
L1IZMIN t • u PERTY LIANUM1 JyJ of t5 - - • -
Tarpaver Name Property Address State Parcel Number Leal Description:
William J/Stacy L Conrad 107 N INDIANA ST 26-02-29-200-000.074-019 E ENLG 34PT/50PT/49
HAZLETON IN 47640
Complete and return to: IIfflh1111[1 1110Il]Dh U[111131!11ll111111 U11][IID111111u111I
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
BART 2:TAXPAYiER 1\F,QRIVIATiIQV
Owner I First Middle Last
illii I I ,n ni )70-E t.._Oil rad
Mailing Address(number and street,city,state and ZIP code) e as properly address
/ad N 7u706 ana 6}-cee4- PO7it/vn -2R/ 1.776$D
First Middle Last
itexi L_ e e �o��ad
Mailing Address(num t,dry,state and ZIP code) I Same as properly address
/07 N i-ti `1tino 9rep,- &iekn .Y.N 4176
y',. , PAR �€ER! IFIGA ION
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
-
,. MAW&ADDITIONAL INFORMATION -
FILED
t
., DEC 3.1 2012
OIBCON COUNTY AUDITOR