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HomeMy WebLinkAboutHomestead_Anderson016 - E o CLAIM FOR HOMESTEAD PROPERTY TAX STANDARD I SUPPLEMENTAL DEDUCTION State Form 5473 (R121 &0g) Prescribed by the Depanmem of Loral Govt mmenl Finance INSTRUCTIONS: See reverse side for filing instructions. FORM YEAR HC10 FILED ILED ICJ CERTIFICATION T I I (We) J certify ttfh pl as my (our) principal place of residence or am (are) buying the following described real property for which a Homestead Property Tax cU n is hereby claimed under contract on the date this applicagon is filed, (date of filing): ' i; i (we) own ❑ Am (are) buying under recorded contract GIBBON COUNTY AUDITOR ❑ Am (are) entitled to occupy as a tenant - stockholder of a cooperative housing corporation ❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified personal residence trust INFORMATION ' CONTRACT •-r r If buying on contract, Fee Simple owners name Recorder's office where contract is recorded Record number Page PROPERTY DESCRIPTION County Townsnip Taxing dishict (city, town, township) Parcel number Legal description Is the property in question: �• S- O ^ , 1 Q ❑ Real property ❑ Annually assessed motile home (IC 6- 1.1 -7) If any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that ssudure is used to produce income, describe the use and portion of the property utilized W produce income. p t &e /1s- 1 _1 1 •9411 PROPERTY BY CLAIMANT IN OTHER COUNTIES County Township Coon Towlstdp I hereby certify the above statements are true, correct and complete. S' tup of i t Address (number and street, aA; • . and ZIP e) w ASSESSOR USE ONLY TRUE TAX VALUE !ASSESSEDVALUEJ AT100%OFTTV HOMESTEAD NON-RESIDENTIA I VALUE VALUE Land not exceeding 1 (one) acre Immediately 'r•,,zfs.j�0'}:.W v surrounding residential improvements. (1) *'".8 r+�-4fi`ir.>; Order land (2) S Total land (line 1 plus line 2) (3) Dwelling (4)rax?sF -y"Cfp Residential improvements or Annually Assessed Mobile I Manufactured Home Garage 5 Other improvements (6) Total Improvements (line 4 through line 6) (7) Total value (I1n e 3 phis line 7) (8) 1 hereby certify the above is true, correct, Signature of Assessor Date signed (month, day, year) . and complete. Verifying anion - Signature of k4tor Date signed (month, day, )ear) STANDARD DEDUCTION 20 pay 20 Lesser of 60% of the assessed value of the homestead or $45,00 ' Notwignslandcg any ofherprovision, (he sum of the deducacns provided in IC 6- 1.1 -12 to a noblie home that Is $ not assessed as real property or to a manufactured home that's nor assessed as real property may not exceed one- hag(1R) of Me assessed value of the mobile home or manufactured home. Signature of Audit" 1 Date (dayl �o ICJ • .Lm nurwssyrokr as n IRiASURLI M0.0 rste r .wRtivEnpy MT 90.0(,oF i cry;Nr:.ti+ ratsvxmeomnu.tnrutacla to:u.cmrxs.u..t rtX'.Ctrca:.t=va Gibson County Auditor • IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS 101 N. Main Street Individuals and married couples ate limited ro one homestead standard deduction.As the receipt of this deduction becomes Princeton. IN 47670 more beneficial,there is more incentive than ever for homest©d fraud.Homestead fraud causes higher tax bills for all:therefor. • IIF.A 1344-2009 requires taxpasers who receive the homestead standard deduction to xerify that they arc eligible ro receive the benefit and to provide additional identifying information necessary to allow county government to better monitor homestead n filings.This information will be kept coral-garb!and can only be accessed by authorized counts officials.The Depanmert of F E T Le local Government Finance will use this information to crate tools that will help county officials eliminate homestead fraud. - PART 1:PROPERTY INFORMATION- ' Taxpayer Name Location Address MAY 4 2012 Rodgers, Ryan Any/\�-\--�c,\\ 620 S OLD PATOKA RD. C. n`_�. " V PATOKA IN 47666 669 GIBSON COUNTY AUDITOR Dan J Anderson II1111111111111101 11 III 111.0111101111011DIID II_IIIIII 111101 01 011111 101 11011 620 S Old Patoka Rd PATOKA IN 47666-9002 111111111111111111111111141"11'11111111111111111111111"11 4'I"Iltlltlll�tllllll�tlllllllr"tlll State Parcel Number Legal Description . a _ 26-04-25-400-000.561-020 PT SE 251 11 .9411 AC 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. r 1 First Middle Last Mailing Address(number and street.city.state,and ZIP code) ® Same as property address 6 sees S. old Pa 9-4., t.at4leG , --um) 'i 7666 Spouse First Middle Last N /A Mailing Address(Number and street,city,state,and ZIP code) - - - . -- - O Same ai properly address - - --' Social Security Number(last 5 digits) Driver's License/State ID Number (las:5 digits) Other(please specify in Part 4 below) I I I I Sore 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 u • Ily,he or she may be liable for back taxes and substantial financial penalties. Owner I Si neN :vtt/1? :: ( r l • PART 4:ADDITIONAL INFORMATION