HomeMy WebLinkAboutHomestead_Sloan (2)CLAIM FOR HOMESTEAD PROPERTY iAX FORM YEAR
CREDIT /STANDARD DEDUCTION i HC10
Stale Form 5473 (R614-03)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing inshuclions- - A 44
(Wei certify � _
I ty the 'ist9if March, 20
I (We) occupi as our princ' at place of residence the following described real property for which a Home aid Property Tax Credit is hereby daimed:
❑ I (We) owned Are buying under contract / �J "�
Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns tfi4` .'pFopvrttl�or.�buying!Uruler,a contract.
T' RECORDED
If buying on contract, Fee Simple owners name
Retarders office where contract is recorded Record number Page
.''%r.ir'"° PROPERT.YDESCRIt?Tl N''zr'�'..0
County
Township
County
Tam di (city,
I hereby certify the above statements are We, correct and complete.
Signature of claimant
Address (number and street, city, state, Zip code)
:gwnship
P27 yrr;rer
L al descd uPp
ASSESSED VALUE
_iAT 100% OFTTV�.
Is the property in uestion:
!/✓)
(.��
�PP-U//1/1`
C.a'S
C�
eal property ❑ Mobile Home (I.C. 6-1.1 -7)
H any portion or the residential structure or the land not exceeding one (1
of the property utibed to produce income.
a that i lately surrounds That stfucture is used to produce income. describe the use and portion
W-' " - tx,m�' . �.�irPROPERTY:OWNED�BY'CLAIMANT p
County
Township
County
Township
I hereby certify the above statements are We, correct and complete.
Signature of claimant
Address (number and street, city, state, Zip code)
Dale signed
T. r +a'.�.L.ls �a a--`,` „y�r t;
'ASSESSOR USE ON'Ys `'
2r.,VALUEY
�3s �
, TRUE TAXIf
F.,t"i
ASSESSED VALUE
_iAT 100% OFTTV�.
_. _ N
.HOMESTEAD
#.VALUE�{'r
` ..z ;.
NON - RESIDENTIAL
biVALUE't: - RV
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
Other land
2
r rn'Y• z
Total land (line 1 plus line 2)
(3)
Residential improvements or Annually
Assessed Mobile I Manufactured Home
Dwelling
Garage
(4)
(5)
:ate'iri,r
Other improvements
( 6 )
s
T RNI
Total improvements (line 4 through line 6)
(T)
Total value (line 3 plus line 7)
(6)
1 hereby certify the above is We, correct, and
complete.
Signature of Assessor
Date signed
Verifying action - Signature of Auditor
Date signed
20_Pay 20_
Lesser of 112 Homestead
valuation or 535.000
$
Signature of Auditor
Dale signed
•
P mu FORM!3MF0R:/tam IREVA1LFi FORM 11A
APPROVED BY CT.UE11000 of Affor.ntS.`Y•1 PLI31I811)BY TIE DEPARTYB"IT OF LOLL GOVZILNMEla FNA.CTE IC 6-1.1-2:4.1
Gibson County Auditor
11 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N
PRINCETON IN 47670 Individuals and married couples arc limited to one homestead standard deduction.As the receipt of this deduction becomes
— molt beneficial,there is more incentive than ner for homestead fraud.homestead fraud causes higher tat bills for all:therefore.
• NEA 1344-2009 requires tatpayers who receive the homestead standard deduction to verify 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 conlidcnlial and can only he 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
Taxpayer Name Property Address
Sloan, Mickey D
P 0 Box 312
Patoka .66
920
Mickey D Sloan
P O Box 312 State Parcel Number Legal Description
Patoka IN 47666-0312
1t1rr11ttt1t11rrrllrrrllrtil Illtttllt tlLlt tt'IIt ItltPlt ll 26-04-24-3000-0 000.256-020 01&oo256-oo WOODS ENLG 58/59
PART 2:TAXPAYER 1NFORNIATION
Owner I First Middle Last
•
ck E")` q w Yx/E SL off tY _
• g Address(number and street,city,suite,and ZIP code) - "' - - - - awe as property nddre„- -- --- —— — - —
Spouse First Middle Last
Mailing Address(Number and street,oily,state,and ZIP code) Same as property address
Social Security Number(last 5 digits) Drivels License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
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 - Date Telephone
( )
PART 4: ADDITIONAL INFORMATION
•