HomeMy WebLinkAboutHomestead_Ellerbrookn
0 ""� CLAIM FOR HOMESTEAD PROPERTY TAX
STANDARD / SUPPLEMENTAL DEDUCTION
S.. Stale Form 5473 (R12/6-09)
r� l Prescribed by the Department of Local Government Fnaoce
INSTRUCT7ONS: See reverse side for (ding instructions.
FORM YEAR
HC1D
1rr� �i
I (we) certify that I (we) occupied as my (our) principal
place of residence or am (are) b "rig the following described real property for which a Homestead Property TaxLStL�dard DYdCcMis hereby claimed
under contract on the date this application is filed, (date of filing): 1
❑ I (We) own ❑ Am (are) buying under recorded contract
❑ 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 the
occupy property under the terms of a quali ftrn(yr de ITOR
INFORMATION
Name o abrupt (legal name)
Sodal Secu ity nunber of claimant (last five digis)
Drivers license / Identification / Other number
Iswing Slate
of daimant (last five digits)
of claimant's spouse (legal name)
Soda[ Severity number of claimant's spouse (last five digits) Drivers license / Identification / Other number Issuing State
of daimam's spouse (last five digits)
CONTRACT ••r r
B buying on contract, Fee Simple owners name
Recorders office where centred is recorded Record number Page
PROPERTY DESCRIPTION
County
Township
'Tax'vlg district (city, toan, township)
Parcel number
Legal tlescription
Is the property in question:
/^�(c�
i-a3 -300-6b, W'
❑ Real property ❑ Annually assessed mobile home (IC 61.1 -7)
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, describe the use and portion
of the property, utilized to produce income. 67 A
PROPERTY OWNED BY
CountyTownship County Township
I hereby certify the above statements are We, correct and complete.
Sigrla of claimant
Address in bar and street, ',state, and ZlPCOde) `
ASSESSOR ONLY ASSESSED VALUE HOMESTEAD NON-RESIDENTIA
AT 100% OF TTV I VALUE VALUE
S R t
Land not exceeding 1 (one) acre Immediately
n
suoundin residential im rovements. (1) - e'- +.x�!r{,,., -_.K, .___i•
Other land
( 2 )
ix
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
q �� `-;�;
'-�5-�'tt• -* ecr^xe>3:
Residential lmprovementsor Annually
Garage
..1 '7°' ^ -_ •� y 1
Assessed Mot fie l Manldis red Home
Other improvements
(6)
rx- v�ilz'v° -x
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(B)
I hereby certify the above is true, correct,
Signature ofAssor
SSe
Date signed (nronth, day, year)
and complete.
verifying action - Signature of Auditor
Date signed (molN, day, year)
STANDARD DEDUCTION
20 pay 20 Lesser of 60% of the assessed value of the homestead or $45,000
-
Abtwith Vandag any otherprowsion. the sum of the deductions provided in IC 61.1 -12 to a nmbrhe home that is
$
not assessed as real property or to a manufactured home that is not assessed as real pmperry may not exceed
one-half (1/2) of the assessed value of the mainte home ormanufactured hone.
-
Signature of Auditor
Date signed (month. day, year)
I/
•
Salt FORM B!Wdl I'-tot tR:ASU RtMW tS.$
APPROVED al_iME EtO\Rn OF AU U?Nf. 04 PRFaCRWFDItV Ile.IRPMtMGVOF LOCAL COVER.''tLCI rtK\CFlfbrt='-n.t
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS -
101 N. Main Street Individuals and married couplet. are limited to one homestead standard deduction.As the receipt of this deduction becomes
Princeton, IN 47670 more beneficial.there is more ireentiw than ever for hmmesucd fraud.Homestead fraud causes higher tax bill:for all:therefore,
11E1\ 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to teethe the
FLED benefit and to prmati additional ept ential and c
and can only be accessed by authorized county officials.The Department of
Local Government Finance will use this information to comic tool:that will help county officials eliminate homestead fraud.
' PART 1:PROPERTY INFORMATION
APR 30 2012 Taxpayer Name Location Address
Ellerbrook, Carolyn E
C.�.M"—."\ 3742 N 225 W
`V\ PATOKA IN 47666
GIBSQCOUNTY AUDITOR
Carolyn E Ellerbrook I III[III-fIIOII_ II oil Immil IIII�iii II0011�iniiv1011�I 110111 �_���������� Ill II
3742 N 225 W
PATOKA IN 47666-9027
1I'1"1'III1II11I 1"1'III"I1IIIrFIII'I'llIIlllIl'lllllll1f1flltl State Parcel Number Legal Description
26-04-23-300-002.405-018 PT E SW 231 11 .86 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•'.
On'I; First -- Middle --- Lai -
l a-rolvn F-. C//erb too
�
Mailing Address(snick/and street.city.state,and ZIP code) it Same as property address
X75402 /Y. CIotc .
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 lD Number (last 5 digits) Other(please specify in Part 4 below)
1 1 1 1 1 I I
Sate
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
•
( )
PART 4:ADDITIONAL INFORMATION
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