HomeMy WebLinkAboutHomestead_Floyd InvestmentsCLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDIT /STANDARD DEDUCTION HC10
State Fomt 5473 (RB / 403)
Prescribed by the Department of Local Govemment Finance
INSTRUCTIONS: See reverse side for filing instructions.
certty thatorirtheil sit d010march, 20_
(We) -coup. s our principal place of residence the following described real property for vihich a Homestead Property Tats Credit is hereby claimed:
❑ I (We) owned ❑ Are buying under contrail %�
Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the prbpehypr:is tiuying,undei a ioritract.
NTRACTRECORDEW-�
II buyutg on contract. Fee Simple owners name
Recorders office where contract is recorded Record number Page
?�.`= " ��14 ' �la�-. � .!?= .tt"��'�di". +�"�iFROP.ERTY, OWNED`, BY; CL'AIMANT,IN;OTHER:COUNTIES't`�
TRUETAX
County Township _
Taxing dis ci , t , township)
b,e{r
;theTownship
al descnp'on
Address (number and street, city, state, ZIP code)
Is the property i uestion:
d�
sf, s�+,�?3vi.�*iYALUE joYravc. ��'
Land not exceeding 1 (one) acre immediately
Red property ❑ Mabee Homo (I.C. &1.1 -7)
un 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
erty utilized to produce income.
=f
r
,Z
(1);
?�.`= " ��14 ' �la�-. � .!?= .tt"��'�di". +�"�iFROP.ERTY, OWNED`, BY; CL'AIMANT,IN;OTHER:COUNTIES't`�
TRUETAX
County Township _
County Tmnshi v
hereby certify the above statements are true, correct and complete.
Signyatt r. of claimant
Address (number and street, city, state, ZIP code)
< }iiSTANDARD:DEDUCTION'ALLO NANCE - l- .�:,�1 n J. y,[uz�'.:
20_Pay20_
Lesser of 112 Homestead 5
Valuation or S35.D00
Signature of Auddor Date signed
TRUETAX
ASSESSE6N AL.I�E
*HOMESTEADS
r"M -.
,e.*.FNONrREStDENTUIL?-: 0-"
.rVN:
e='4T 00°,6'OFw,TiN:
t..�. '-•V E i
sf, s�+,�?3vi.�*iYALUE joYravc. ��'
Land not exceeding 1 (one) acre immediately
=f
r
surrounding residential residential improvements.
(1);
3 ' ,3�.- «rYa,C
Other land
(2).d;�,
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
r��;�� � �t,• °,��__+,�_ a,. �:,t,yr£:;;,,
tai :.:-s
Residential Improvements or Mnuudly
. .�t.�:3,✓:tenSanvss,.t�i.ti"f?ti. a
Assessed Mob% / Manufactured Home
Garage
(5)
+.-=
Other improvements
(6)
=•��- _''� -y4<'-
"` :':Y;r
Tdal improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(B)
I hereby certify the above is true, correct, and
Signature of Assessor
Data signed
complete.
Verifying action - Signature of Auditor
Date signed
< }iiSTANDARD:DEDUCTION'ALLO NANCE - l- .�:,�1 n J. y,[uz�'.:
20_Pay20_
Lesser of 112 Homestead 5
Valuation or S35.D00
Signature of Auddor Date signed
STATE rORM DNA at:rravel TREASURER FORM CIA
rINIPOR7ANT NOTICE TO HOMESTEAD rPROPERTY OWNERS 4-11-2_,R.
Gibson County Auditor
101 N Main
PRINCETON IN 47670 Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than eser for homestead fraud.Homestead fraud causes higher ax bills for all;therefore.
® HEA 1344-3IX0 requires taxpayers who receive the homestead standard deduction to verify that they arc eligible to recebe 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 Depanntrnt of
Local Govenunent Finance will sec this information to create DO'S that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Floyd Investments
350 N/550 W
Patoka IN 47666
2776
Floyd Investments
2118 W 350 N • State Parcel Number Legal Description
Patoka IN 47666-9023
11 11 III I I 1 1 1 1 1 1 I I I I III I I I I 26-04-23-300-001.926-018 010-01926-00 PT SW 23-1-11 18.6179 AC
r n ur r ur rn 11 r u not r u rue ii t 11 r \/X`/ D-15 C-1
/
PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
- ®ig Address(number and street,city,state,and ZIP code) Same as property address--
a \ k % l ) 350 N PA*-0 -1\ j. >J `t'1 bc0 Co
Spouse First Middle Last
Mailing Address(Number and siree4 city,stale,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)
•
sae
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 eliuible 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 Sign // / Me Date
PART 4:ADDITIONAL INFORMATION