HomeMy WebLinkAboutHomestead_Collins STATE FORM !aIM_ '.1") TREATUAPR FORM IS-IA
APPROVED BYZIVE WARD or W' isaro IEFYTIBEnnYntrDEPARnc4T(w LOCAL GOVERNMENT MDANCEre it-rJ.I
Cyibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead standani deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than ever for homestead fraud.Homestead fraud causes higher lax bills for all:therefore.
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to recene the
benefit and to pnwide additional identifying information necessary to allow county government to better monitor homestead
filings.ibis information will be kept confidential and on only be accessed by authorized county officials.The Department of
local Government Finance sv ill use this information to create tools Mat will help county officials eliminate homestead fraud.
PART 1: PROPERTY LXFORNIAT1ON
Taxpayer Name Property Address
Collins, John T
R3 Box 120
_ Oakland City IN 47660
3270
John T Collins
R3 Box 120 State Parcel Number Lezal Description
OAKLAND CITY IN 47660-7753
itlullntl tllntll nll ntlntllu tltltlullltlrinlu tll tl ttl 26-20-14-302-000.102-001 001-00102-00 PT NE SW 14-391 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
`\c Vs al -v COI) : 5
aline Address(number and street,city,state,and ZIP code)) 1) p Same as property address
9'75 '7 8. 7005 VAC1A4C eHly Li 7 (0(00
Spouse First Middle Last
Mailing Address(Number and street,city.state,and ZIP code) 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)
-- - - sys_ _..
PART 3:CERTIFICATION _Each undersigned certifies,under penalty of perjury.that the above and foregoing information is time 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 1$' Ii Date l
Nn . CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
S f State Form 5473 (R4I b-00)
u.
INSTRUCTIONS. See reverse side for filing instructions.
h1
FORM YEAR
HC10
I (We) r 1 �`-'— - — oe that on the'Ts(d 'af9d�kh!10_
I (We) our principal place of residence th ollowing described real property for which a Homestead Prop�}y,Tac radityp ggreby claimed:
UCI. �4 LUUI
W:'11(We) owned ❑ Are buying under centract /` �/
.Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns t1(g' property or igbuyteg under a "rcontrad.
1f buying on contract Fee Simple owners name
Recorders ofice where contract is recorded
Record number I Page
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Couny
County Town '
Township Tmdng di ,own, row hi
_
(portion
VALUE .x
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dascription
It any of Ne r sideRial structure or the Wand 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.
/0 -600
rr. ;�-a”-
- - ;-:;:.PROPE_R_TY ;OW_NED
'ASSESSEDbVALUE'
County -
Township
County Town '
I hereby certify the above statements are true, correct and complete. 4
Vgnatu rimant
VALUE .x
S c��
(number and stree
IF �2
,state, ZlPF;)
v l�
,(1)
6'',ms- �m'`cai-
r T MT' +tT OWN
"1,�A,SSESSO USEONLYr4flVAI`
UE'TAX -
'ASSESSEDbVALUE'
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rHOMESTEAI
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VALUE .x
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VALUE,;j.'''
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Land not exceeding 1 (one) acre immediately
,(1)
surrounding residential improvements.
- :,.e^Mr'�
Other land
(2)
� a4 � -�
IDEA
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
" x
y >' ? ^`- a^ '
Residential improvements,
Garage
(5)
, y
. — `-
Y �
Other improvements
(6)
Total improvements (line 4 through line 6)
i7)
Total value (line 3 plus line 7)
(6)
I hereby certify the above is We, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
�' ".`.'"s:,�+'':STANDAFiD'- DEDUCTION
ALL04VANCE�.gy-= = �T$r�;aT3S
20 _ Pay 20
Lesser of 12 Homestead
$
V atio r $6,000
Signature of Auditor
Date si