HomeMy WebLinkAboutHomestead_EvansCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (R614-03)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instnx6ons.
FORM YEAR
HC10
F L D
certify that on the 1st day of March, 20
(We) occupied as our principal place of residence the following described real property for which a Homestead Property Tax Cre it is hereby claimed:
❑ [(We) owned ❑ Are buying under contract o1 �� /G I�11 q�
Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the properdrtis I�uyiriiX a contract.
- _. v`_-?,-_,: s` 'rrt«-- z...�'1"si_i•_'r'tx'u'`, -�' - ...:.,ro;..
It buying an contract. Fee Simple owners name
Recorders office where contract is recorded Record number Page
u?: xP! sr'?. g- P,ROP.ERTY,OWNEDBYCL'41MANTaIN: OTHER` COUIJTIESf.. `.?•_'y.aiQ''- t''.`: ?•, =,x'" - "ro
...4jPROPERTY..OESCRIPTIOW% =�•
County
Township
Taring district (city, to
a n i
Pa[tl n�W(gber
L descriP
u
Other land
Is the Property in question:
U ll o' T
?`- r
W
Real property ❑ Mobile Homo (LC. 6.1.1 -7)
If 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.
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County Township
County Township
hereby certify the above statements are We, coned and complete.
Signatupkv claimant /)
!may
dress (gum er and sf.2et $ ate, f coda)
S�
cJ!
�'^.,'.�� ASSESSOR USE ONLYr
f TRUET�'i
ASSESSEDVALUEvHO1dESTEAD'
T'ATs100 OF "TTV_VALUEy
N N ESIDENTIAL r.• }i
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
u
Other land
(2)
?`- r
W
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
\ �5p
Residential improvements or Annually_
MEMO
Assessed Mobile I Manufactured Horne
Garage
_
Other improvements
(g)`
: ^.
Trial improvements (line 4 through line 6)
(T)
Trial value (line 3 plus line 7)
(S)
1 hereby certify the above is true, coned, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
20 _ Pay 20 _
Lesser of 1t2 Homestead
Valuation or E35.000
I
o - STATE FORM 13509(111 410) TREASURER MINI TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS.20C - nswsmsn BY TEE OEP.ARTME•T OF LOCAL GOVERNMENT FINANCE IC 6-1.1-224.1
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N.Main Street Individuals and married couples are limited to one homestead standard deduction. As the receipt of this deduction becomes
Princeton, IN 47670 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 idrntifiing information necessary to allow county government better monitor homestead
F filings.This information will be kept confidential and can only be accessed by elp co zed county officials.The Depaad fra of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART I: PROPERTY 11 FORMATION
APR 5 2011 Taxpayer Name Location Address
Evans, Courm/Ellen I
C �•� 3045 Main -
iRBSON COUNTY AUDITOR Patoka IN 47666
Courm Evans IhiII.11011 ICI 11111101111111011111111111_IIIIUhI II11IIll IdII
304 S Main St
, PATOKA IN 47666-9000
'I'I'I'II"1111'IIII'1'IIIIIIII''ll�"IIIIIII'I"I�IIIIIIII'lllll State Parcel Number Legal•Description .
— — _ 26-04-25-102-000.140-020/SMITHLAND DIV 25/26 PT NW
{/ 25 1 11 1.35 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.
Ow.._. I First Middle Last_—
A 0UR M e �v �Ns
Mailing Address(number and street,city.state,and ZIP code) came as property address
r
30* s, /HAIIv ST/ filoPAIN L/ 774
Spouse - First Middle _ - Last
Le �v �T v � Ais
_�.. Mailing Address(Number and slreeC city,stae,and ZIP code) - OCallit as Pro'peity address--__
30 S' /tip/ i .�'r. pAT4A)
' --
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 fmancial penalties. • ,
Owner 1 ignature Date
•