HomeMy WebLinkAboutHomestead_Scottate?° CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDIT /STANDARD DEDUC jpN HC10
State Form 5473 (R2 15-92)
race
INSTRUCTIONS: See reverse/ 9f i instructions.
W.) I WV's ` /�_1i4 .01,11 v.� YI certify that on the t st day of March, 19
es) occupied as our principal pl f residence the following described real property for which a Homestead Property Tax Credit is hereby claimed:
45 �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 Pvmrygrri&bu%6Q an era contract.
CONTRACT RECORDED
If buying on contract, Fee Simple owner's name NNK I b 19.9.1
Recorder's office where contract is recorded ecortl numyg -r y Page
" PROPERTY DESCRIPTION
County -
Township
Taxirg district (a
Township
Parcelm bar
d Veb o %7- fl o
Legal description az (0 111
Address (number and street, city, state. ZIP code)
L
VALUE
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, destibe thg use and portion
of the property utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
Township
County
Township
feby certify the above statements are true, correct and complete.
Signature of Uaima
Address (number and street, city, state. ZIP code)
L
ASSESSOR USE ONLY
TRUE TAX
ASSESSED
HOMESTEAD
NON - RESIDENTIAL
.VALUE
VALUE
VALUE
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
-
Other land
(2)
Total land (line I plus line 2)
(3)
Dwelling
(4)
Residential improvements
-
Garage
(5)
I.
/
Other improvements
(6)
t
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(g)
1 hereby certify the above is true, correct, and
Signature of Assessor
Date signed
plate.
Wing action - Signature of Auditor
Date signetl
19_Pay 19_
Lesser of 1/2 Homestead
Valuation or $2,000
S
4
-T
-
STATE FORM 53544 OW 610) TREASURER FORM TNIA
• APPROVED BY STATE BOARD OF ACCOUNTS.'04 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FMANC IC 6i.I'134-1
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,
F es ' HEA 1344-2009 an provide regdi es taxpayers identifying receive the anon ece standard IIoQ con to government that they are eligible
ni monitor homestead
the
benefit and to prmide s taxpaye vtho rece ie the home necessary to allow county verify meet to better monitor homestead
• Slings.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 create tools that will help county officials eliminate homestead fraud.
;PART 1: PROPERTY INFORMATION
APR 18 7r1t Taxpayer Name Location Address
c.3. Scott, Michael Thomas
0 CHERRY ST
•-.GIBSON COUNTY AUD TOR PATOKA IN 47666
510'
Michael ThomasScott II01�I;II_�IIDII II IIIIBIBII�IIII�IIII��IIDII_II IIIDI�IIIII_III�II�II0IDIIII]II
c/o Mark Scott
PO Box 18
PATOKA IN 47666-0018
IIIIIII'll"llIlIllllI"IF111111 r1"I"11II'11II'I1III'I1I1IIII1I State Parcel Number Legal Description
26-04-24-303-000.087-02('1/COL DIV OUTLOT 5 PT/8 PT
•
9
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_TA\PAYE' INFORtNIATION_—_ _ - 3 _. __
Ow C..r l First - ( Middle Last~
14-4 P k __1?c ; C s c. 6 Tr-
Mailing Address(number and street.city,state,and ZIP code) I ❑ Same as property address
P,a' iC PerLi 7666Cch =°rr )t S 3 )
Other(please specify in Part 4 below)
Spouse Fiirstl Middle - Last
Mailing Address(Number and street,city,state,and ZIP code) 9 Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
—
I I I I I I I I I I sme
I PART 3:CERTIFICATION j
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 -
• Signature Date Telephone
PART 4: ADDITIONAL INFORMATION