HomeMy WebLinkAboutHomestead_Danels---1
CLAIM FOR HOMESTEAD PROPERTY TAX FORM FYEAR
CREDIT/STANDARD DEDUCTION HC10
State Form 5473 (R5/ 10-0I)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for riling instructions-
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I (We) ae V- C ft 4 CJ 12-1 -1 e certify that on the 1JAVJW—rc�uV3�
I (We) occupied as our prikcipai place of residence the following described bed real property for which a Homestead Propert ax Credit is hereby claimed:
❑ I (We) owned ff?<re buying under contract �11
0 ',3ve a beneficial interest in the entity that is liable for the property taxes on the property and that owns the prop4ordr A�bwpo-kwlzrl�a tarthd
sbuWnuN I I AUDITUR
NTRACTj RECORDED ir4"'
If bV on contract. as Si a name
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K)ice
Recorders office where contract is recorded Record number Page
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V ;'n --z -M�- ROPERTY,-DESCRUPT160
Court
Township
County
Taxing district (city,
ip)
Signature
Signature of I m
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surrounding residential improvements.
Parcel number
Legal description
Is the property in question:
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I Q1AVSrP-'-p-rTy ❑ Mobile Home (I.C. 6-1.1-7)
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If imtrti-.npa� residential structure or the land not exc4ding one (f) ace that immildiately surrounds that structure is used to produce imxvne, describe the use and portion
of the property utilized to produce income.
(2)
'w-Wr--.W PkOPlfkTYbWNEd?BY
County
Township
County
Township
I hereby certify the above statements are true, correct and complete.
Signature
Signature of I m
M.
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ress (;umber � s ZIP code) A -h -
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VAL U
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ESS Wi.
ON
TRUE TAX .0z
ASSESSED
A 9D-i�E
6�; OWii 6!
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? :j� �NON�RESIDENTIAV
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Valuation or $6.000
VAL U
4
Land not exceeding I (one) acre immediately
171
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surrounding residential improvements.
Otherland
(2)
Total land (line I plus line 2)
(3)
Dwelling
(4)
5.
Residential improvements
Garage
(5)
4w
Other improvements
(6)
Al i�.'
Total improvements (fine 4 through line 6)
(7)
Total value (line 3 plus line 7)
(8)
1 hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
TANDARDMEDUCTIONALLOWANCE
20 _ Pay 20
Lesser of 1/2 Homestead
Valuation or $6.000
Signature of
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STATE FORM Mt.lt2/.-041 TREASURER FORM StA
APPROVED MPORTANT NOTICE TO HOMESTEAD rPROPERTY ROWNERS 1"'
Gibson County Auditor
101 N Main
PRINCETON IN 47670 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 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
hlinp.This information will he kept confidential and can only be accessed by authorized county officials.The Department of
Local Govcmment Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Danels, Jeremy K/Natalie M
110 S Indiana ST
Hazleton IN 47640
53
Jeremy K Danels
110 S Indiana State Parcel Number Legal Description
HAZLETON IN 47640-8900
Itl11IIt11Itllrttlttlllttllrrlrlrltrlltttll IIII III 26-02-59-033-000.211-019 014-00211-ODE ENLG 108 PT/109 PT
This form MUST be returned to County Auditor's office.
Please do NOT send this form back with your tax payment to the county treasurer.
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
Ter emi \A', ck Dane-\5
ilmg Address(number and street,city,state,and ZIP code) ® Same as property address
10 S. I nd'lurlcx Si, Ha-LAC.j0t\ f 1 N 91(tiO
■
Spouse First Middle Last
N ate\',a Mar; e_ 0 a net s
Mailing Address(Number and street,city,state,and ZIP code) E Same as property address
\IO Si I no�'lana St. 4atIt\-0I\ I N y1�t- o
_
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.
Ow I Signature Dam
PART 4:ADDITIONAL INFORMATION
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