HomeMy WebLinkAboutHomestead_LloydCLAIM FOR HOMESTEAD PROPERTY TAX
STANDARD /SUPPLEMENTAL DEDUCTION
State Form 5473 (R13112 -09)
y� Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side Tor filing instructions.
FORM
HC10
- s 4f, .. ..,"� .;aT.-..�%u,,u lCERTIF .ICATION'STATEMENT°K`,:�s�, = c�� ;;.£3'•_'�:`3c.kbv':"`Y'r3" +r v: ��. "'4_'
buying the I�lonvm JTedficin ad
place of idence or am (am) 7d,,wbd real property for h,,h a Homestead Property Tax StaitAirt
—Aer contract on the date this application is filed, (date of rding). I (We): ']Fne"V
Own ■ 1
F1 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 msiLhkq!;q, '11�
■ Am (are) the shareholder. partner or member of the entity that owns the property.
�tTq'ni'k'Y'CL3'AIM ANTSINFORMATIONa .4',:�':.iv1ry.kk:
Driver's license I Iderltifimtkin
of claimant (Last five digits)
Social Security number of claimant's spouse (hist F" digAls) Driver's license I Identification I Other
of clalmant's spouse (last r" d4b)
.:` <i `.¢•;.iv i,,:i:._ �.':�ai.ti .1 r_.t .5.`a - 5 CONTRACT'RECORDED ?y ..US:.wr+ aeT:£r.".7'r�}r..f
>..�t_�g;'o IP,ROPERTY�DE
g
:' �'_ ■ . _ ....
of the property utdtmd M produce incorna-
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PROP ERTY:OWNED'BY,CLFAIMANTi:IN OTHERCOUNTIES",u?q�'�?w;'•.y' �_ „.'dw,;:- ,'{_ „_, :, ;s .,r,
r._, yl,
SSESSOR USEONLY'2`Li gy tiIYTRUE
TAX VALUE,TjI
ASSESSED VALUE'IHOMESTEAD[ar3`+NON
AT.S100- j.z3�nV AIIUE�o_
RESIDENTIAL.FS
,_ri. .rz.i1VAI'UE.
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STANDARD' DEDUCT(CNW LOWANCE .�s*' ;N
20 pay 20 Lesw of 60% of the assessed value of the homestead or $45,000
NotwittistandkV any otherprovilsion, the win of the deductions provid6d in IC 6-1.1-12 to a mobile tiom that is
not assessed as mi property or to a manufactured tx�m that is not assessed SS real property My not exceed
one-haff (u2) of the assessed value of the mbd
STATE[(WI 55#5 40 ryat 1R`ASURER FORM IS-1A
APPROVED Bl'STATE 30150 Or At((CNN.2;1. FRSSC•IED BY TW OEPARTMEU Of LOCAL COVkK•'IE>T ILW,CE IC l: +}E.t
re Gibson County Author IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS;`
101 N. Main Street Individuals and married couples are limited to one honiecead standard deduction.As the receipt of this deduction becomes
Princeton, IN 47670 more beneficial.there is more ircentive than ever for honustetd fraud.Homestead fraud causes higher ax bills for all:therefore,
PI LET) UFA 1344.2009 requires taxpayers who receive the homestead standard deduction to>erifv That they are eligible to receive the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will be kept confidential and can only be accessed by authorized county officials.The Department of
Local Government Finance will use this information to crectc tools that will help county officials eliminate homestead feud.
— MAY 1 ZO1Z PART 1:PROPERTY INFORMATION
Taxpayer Name Location Address
C Lloyd, Jackie E
—
129 E CROSS ST
GIBSON COUNTY AUDITOR PATOKA IN 47666
475
Jackie E Lloyd II I I I I_f II II III III li QII I 111111 _III II_II_in ill II I Hill Ill ID i1 II
P O BOX 203 •
PATOKA IN 47666-0203
1"11111111111"1"111111111111111"1111111111111111"111111111 State Parcel Number Legal Description
26-04-24-401-000.309-020 PT W SE 24-1-11 .333 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.
N. , . y I .I • /-A ---
r I "2C\is,gre• First Middle Last
-S-&CQ tkP LrJ 2 Lr /; roP.
LA-, Le f (1-1,0 \
Mailing Adds umber and street,city,sane.and ZIP code) El Same as property address
? 9 - - cPp_IDR ? ir 0. 7/010
Spouse First Middle Last
Mailing Address(Number and street,city,state.and ZIP code) ❑Same as property address
Social Security Number(last 5 digits) Drivees License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
_ I I I I I state
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 Signature// � 77 7, Dace
dust:gnamre /� Date Telephone ( )
PART 4:ADDITIONAL INFORMATION