HomeMy WebLinkAboutHomestead_WeltonCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (R614-03)
Prescribed by the Department of Local Government Finance
a ST� r T
FORM � _�
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HC10 I I 2 '21
1 (We) 7- certify that on the 1st day of March, 20
1 (We) occupied as our principal pia resi the following described real property for which a Homestead Property Tax Credit is hereby claimed:
�f 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
ts, d` s, R" z�3J }�CONTRACT.iRECORDEDseri.9ifs �>k�, y'�'.'ar• ?s kyyEa"a„- �.,�r*sa ,::rr
If buying on contract. Fee Simple owners name
Recorders office where contract is recorded Record number Page
ROFERTY: DESCRIPTION +`:`:r��NW-VV _�,_�.s -',�4 ..�. -u�' iii:? z^• �i7`�.`_,,.- �- _1't"sk,�._:':1.
County
Tavnship
Taxing district (city
o ip)
Parcel number
1 d ripti �
the ro
p pertyi 'on:
VALUEt
=��'- VALUE�s,'
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
Real property ❑ Mobile Homo (I.C. 6-1.1-7).
If the portion of the residential s cture or the land not ex ing one (7) acre that immedi ly /�r,�rroJ�nds that
party utit¢ed to produce income. // j / Cj'O
Cure is used b produce income, describe the use and portion
0?6 -0 0? - 9 033 - low. i� 9 -0/9
Other land
'v�?���_ASSESSO�R�SE„ONLY t�^Y�VAI:UE:
County Township
County Township
I hereby certify the above statements are true, correct and complete.
ture of claimant
ress (number and street, city; state, 21P code)
®o% S. oF�lo } Act c, rj t4.
Y L-1 C)
'v�?���_ASSESSO�R�SE„ONLY t�^Y�VAI:UE:
y-TRU AX
ASSESSEDVALUE
E -MESTEADr
's�`�v
;`NONRESIDENTIAL
a�
-i ,r'c_
?AT�t00Yo_ -OF TfV
VALUEt
=��'- VALUE�s,'
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
mss" 'e@
;. ?,ti4 ry.,
.
Other land
(2)
§
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
y QTY '2Pj
s �� -�1�
IResidentiel improvements or Annually
�tiy3" kk�k
ra, _
:
Assessed Mobile / Manufactured Home
Garage
(5)
;�- !
rr..±�T,s�W�s'.�i
Other improvements
(6)
W
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(6)
1 hereby certify the above is We, correct, and
Signature of Assessor
Date signed
complete.
Vedlying action - Signature of Auditor
Date signed
i '..'6' ..#R' ?rv`3�la'i`•,_'`v,? =;r3� x "STANDARD:DEDUCTION'ALCOWANCE'
20_Ply 20_
Lesser of 112 Homestead 5
Valuation or 535.000
Signature of Auditor Date signed
•
STATE FORM W M.IR:/1-N1 IFLISlant PotM TS-IA
APPROVED BI(TATE BnvRD OF 100111INTa.9r, ptrAWBED BY 11W DEPARMEYT OF1MAt rOSRLVMn,,FINANCE W€1.1-_3.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individua6 and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial.there is more incenthe than ever for homestead fraud.Homestead fraud causes higher in 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
filing.This information will be kept contidemial and can only be accessed by authorized county officials.The Department of
Local Government Finance will taste this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Welton, Dennis E/Jayne A
309 S Ohio ST
Ilazleton IN 47640
50
Dennis E Welton
309 S Ohio State Parcel Number Legal Description
HAZLETON IN 47640-8906
III I III rrr I rr I r I r I mm I I mmm I I I I rrr I I I I I 26-02-59-033-000.159-019 14-00159-00 E ENLG
r rr rrr r rrr rr m mm m rm rrr 115/116/117/118/119/120
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
tg Address(number and street,city,state.and ZIP code) J 16 Same a property address- —
Si o%1io Sr: /IA2LLTO 1 `h6 c/u
,
Social Security Number(last 5 digits) Driver's Lic nse/State ID Number (last 5 digits) Other(please specify in Part 4 below)
303—leg-1 237 stme.— /
Spouse First Middle Last
JAynla PA/AI kiEpro1J
Mailing Address(Number and street,city,state,and ZIP code) 54 Same as property address
5497 5' Ct i° 57, /417[FTwJ 1 1J 47(; 6
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Pan 4 below)
._— _313'2,2- 5g2� _ 5ni Otfw —ca—ll-L/ /
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 or back taxes and substantial financial penalties.
Owner turc One Telephone
//r (- 6 // b L /0 3a-- ( ) `7e y-i y1 7
Spouse Signanre ,, //� Date Telephone
Al"- G�/ 5/ZS / 0 (Pi2 ) 78�-2q(
PART-4:ADDITIONAL INFORMATION.,a