HomeMy WebLinkAboutHomestead_France±� CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDIT /STANDARD DEDUCTION HC10 b
State Form 5473 (115110 -01)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
";`'r �� CERTIF.ICATIONSTATEMENT?
I (We) c ify t1 o tileils a�o A%A. 20
1 (We) occupied as our prir6pal place of residence the following described real property for which a Homestead PrMopev„y Tax Cr�)d t hereby claimed:
t1k, (We) owned ❑ Are buying under contract I I 1I 8 `�t
Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns/ property orjis b�XIng undgg a contract.
If buying on contract. Fee Simple owners name
Recorders office where contract is recorded
Record number I Page
r'
cF?'
f�:.`? P. ROPERTYOESCRIP. TION ';'w'?,:`z"§�v�= ti.�,",iu",wt
County
Tornship
To mship
Taw t ict wn, towns t#)
�o d
Ign ,u t Iajtnant
d,,*.a,.._ <rt,•j.""; VALUE'S �$'�°.�
+r ss (number a street, city, state, ZIP code)
P r ^a /nyrpberCo g� / / O 0
//1 C
L al
n ti Y—
Is the property in question:
S OY /l-
(1)
-
❑ Real property ❑ Mobile Homo (I.C. 6-1.1 -7)
If any portion of the residential sWcture or Ne land not exceeding one (1) acre that immediately surrounds that structure is used to produce income, describe the use and portion
of the property utilized to produce income.
ROPERTY,OVYNED:BY CLAIMANT;INOTHER'000NTIES Fi'- rl.'ay "'�"i.'""'r ..`'"rt-'^
County
Township
z,.HOMESTEAD
County
To mship
hereby certify the above statements are We, correct and complete.
T,L 00%OVALUE
_AT�100 %_OF ITV
Ign ,u t Iajtnant
d,,*.a,.._ <rt,•j.""; VALUE'S �$'�°.�
+r ss (number a street, city, state, ZIP code)
ASSESSOR USE ONLY a >
r TRUETAXX�3
�r�VAL_UE:<
A
z,.HOMESTEAD
NON= RESIDENTIALT`J'A
.
T,L 00%OVALUE
_AT�100 %_OF ITV
s VALUE
d,,*.a,.._ <rt,•j.""; VALUE'S �$'�°.�
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
L �v"-•#
Other land
2
x €,
Total land (line 1 plus line 2)
(3)
Ne -10.0. M.
Dwelling
(4)
j''4�
a
�!s
Residential improvements'"�'r�``s�_
Garage
(5)�
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(S)
1 hereby certify the above is We, corned, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
20 _ Pay 20 _
Lesser of 112 Homestead
Valuation or $6.000 S
Dale signed
•
STATE FORM!)NIt_I,nn•1 TREASURER FORM TS-IA
APPROVED By STATE.BOARD OF YALICPM D BY T11E DEPARTtEVr Or LOCAL OOVERNMETT TPA\CE Mf-I.IS:-tl
Gibson County Auditor
101 N Main IMPORTANT:NOTICE TO'HOMESTEAD PROPERTY OWNERS
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 particle additional identifying information necessary to allow county government to better monitor homestead
filings.This information will he kept confidential and can only be accessed by authorized county officials.The Department of
Local Government Finance will sec this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
France, Philip
6 RI Box 28 A2
Patoka IN 47666
33
Philip France
109 West Street State Parcel Number r/ Legal Description
Patoka IN 47666-9017
lilii lliiililliiill iuillinliliill ll�ttt 111 iuili�tt ulilil 26-04-26-202-000.524-020 019-00524-00 PT NE 26-1-11 .34 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.
PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
pk-1 ;f pRoncr
ng Address(number and street,city,state,and ZIP code) l Same as property address
JO u) es-t 3-6reej- Z4 fir Lam . 7/II
Spouse First Middle Last
S nlie
Mailing Address(Number and street,city,state,and ZIP cock) El Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Pan 4 below)
slam
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. -
Owner I Signature Date
Spouse Signature Dal Telephone r l
PART 4:.ADDITIONAL INFORMATION