HomeMy WebLinkAboutHomestead_FordCLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDIT /STANDARD DEDUCTION HC10
Stale Form 5473 (R614 -03)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
I (We) certify that on the Nst day 0of LU0A
o r _
I (We) occupied a pn i I place sidence the following described real property for which a Homestead Property T�henib//d:
❑ I (We) owned Ave buying under contract ,f-r
i Have a beneficial interest in the entity hat is liable for the roe taxes on the roe and that owns the roe �Wlss% n rrvrn�
tY property nY property nY P P rty buying under a tw LR
nY?. �e:J ?irsJbis. a` 4CONTRACTaRECORDEO�_:.'_" ey'= t±` _ia.•„- -.- r`T`st•;`.Y,...._ -.;>
If buying on contract, Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
-- - - - L - - '(5TH - --
�-r. =' ROP ,ERTY,OWNED'BYCL'AIMANT;IN'ER" COUNTIES
PROPERT. Y: DESCRIP- TI6Na' rFk ;P,`.".<'E`—-- zrra%ft$va'�i,?4
County
Township
Taring district (city, town, township)
Parcel n yer /
eg cot
%-1-10
Is the property in question:
C1 Real property ❑Mobile Homo (I.C. 67.1 -7)
If any portion of the residential structure or the d not exceeding o me
one (1) acre that imdiatey( surrounds
unds that structure is used to produce income, describe the use and portion
of the property utilized to produce income. /Do-w'
Q5`7- 160. r�o W
-- - - - L - - '(5TH - --
�-r. =' ROP ,ERTY,OWNED'BYCL'AIMANT;IN'ER" COUNTIES
County Township
County Township
1 hereby certify the above statements are We, correct and complete.
na a of 1 t
Addr (numberard street, cdy state, ZIP code)
Imo/` O
3 r %gyp' 3 "�i 1ls Z "F£7
rY,_- ._4
c 4 wr
r
ASSESSED VALUE
C- w'HOVALUE
-.
N
x`?°re�e '..cam r
�•vV/1L.0
- VALUENx',44
Land not exceeding 1 (one) acre immediately
"`� crs°`�•- c`$y.` -?.
surrounding residential Improvements.
Other land
(2)
p N.
`
3.�?r'm= - t,
;arm..
Total land (line 1 plus line 2)
(3)
Dwelling
()
�_
Residential improvements or Annually
rn
Assessed Mobile I Manufactured Hoe
Gra y
e a
6
� ` °� t7F,
� ngzm
()
Other improvements
(6)
AM 0� 'i
Total improvements (line 4 through line 6)
(7)
Trial value (line 3 plus line 7)
(6)
1 hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
20 _ Pay 20 _
Lesser of 1/2 Homestead
va tabon or 535.000
Signature of Auditor
- • 515£FORM 5 S'M,R_/•41.1 11tWASt:IFA POR.4 TIA
.APPROVED BY sl:TE!WARD OFMYRt\T5._nn PRh'LA®FD BY MME BFPARTY¢YTOF LOCAL o vErerm AT FINANCE IC.11-1.1-L4.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples arc limited to or homestead standard deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than escr for homestead fraud.homestead fraud causes higher tai bills for all:therefore.
• HEA 1344--3009 requires taxpayers who meek e the homestead standard deduction to verify that they are eligible to recehe the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
tiling,.This information will be kepi canfdemial and can only lv screwed by authorized county ofbci;1 fli Depann of
Local Guvenm,ent Finance will use this information to create tools that will help county officials.elininatc homestead Mud.
PART 1: PROPERTY INFORMATION
_ Taxpayer Name Property Address
sidtz
Ford, John R/Barbara J Trust/ B 395- Ov )�2
Jeffrey Qco
0.'cll q l _ /L
Teton IN 47610
John R Ford
• e
/ 2552 E SR 56 State Parcel Number Legal Description
Hazleton IN 47640
26-02-58-047-000.804-018 010-00804-00 PT MD 47 1-10100 AC
PART 2: TAXPAYER INFORMATION
Owner I I First Middle Last
EF FRED - rt _ _ - F®R� --••tg Address(number and street,city,state,and ZIP code) fl Same as property address
e5S Eft. ail 6" 4, eu,e70A9 ( 3.to g21d-to
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/Slate ID Number (last 5 digits) Other(please specify in Part 4 below)
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 Signatur Date
PART 4:ADDITIONAL INFORMATION
•
1