HomeMy WebLinkAboutHomestead_MellorCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
Slate Form 5473 (R817 .07)
s
Prescribed by the Department of Local Government Finance
INSTRUCTIONS., See reverse side for filing instructions.
•: A �
�' r MN
MAR 1 0 2009
I (We) ce ,y�aff, th st day arch, 2(1_
I (We) occupied as our prin 1 place of residence the following describ real pro rty for which a Homestead PrroXtFWeQit daimed:
01 (We) owned C) Are buying under oonbad
J Have a beneficial interest in the entity, that is liable for the property taxes on the property and that owns the property or is buying under a contract.
CO •••
If buying on contract, Fee Simple ovmees name
Recordef's office where contract is recorded Record number Page
PROPERTY
Cou Ta hip Taxing district (city, f , I s
?(� I— Legal descdptim I Is the p to question:
_ —l/t7L eel property ❑ Mobile Home (IC 61.1 -7)
"I portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that stricture is used to produce mme, describe the use and portion
of the property utiGred to produce income.
ASSESSOR USE ONLY
TRUE TA� VA�UE
ASSESSED VALUE
HOMESTEAD
NON-RESIDENTIAIL
AT 100% OF TTV
VALUE
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Other lard
(2)
Total land (line 1 plus line 2)
(3)
F
Residential improvements or Annually
Dwelling
(4)
Assessed Mobile I Manufactured Home
} }r �r �, ,r . t.
Garage
(5)
Other improvements
(6)
t'
Total improvements (line 4 through Gne 6)
(7)
Total value (line 3 p1w Gyre 7)
(8)
1 hereby certify the above is true, cortect, and
Signature of Assess«
Date signed (month. day, year)
complete.
Verifying action - Signature of Auditor
Date signed (month, day, year)
STANDARD
20 _ pay 20_ 45,000 for 2007 pay 2008 42,000 for 2010 pay 2011
Lesser 44,000 for 2008 pay 2009 41,000 for 2011 pay 2012
Homestead Valuation
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or 43,000 for 2009 pay 2010 40,000 payable after 2012
S' of
for
Da (rpmlh.
ear)
STATE FORY!)W OW YPt TRL SURIR FORM:3-IA
ArPRP'ED BY R.ATE tooLoor ACMNTS.9n PILFSCIIarD BY THE DEPARnne r(r LOUL GJr2RA'MrAT FINANCE IC LI-r•-4.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 IndividuaLs and married couple.are limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than eta for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
® HEA 1344-2009 requires taxpayers who remise the homestead standard deduction to verity that they are eligible to receive the
benefit and to provide additional identifying infonnanon necessary to allow county government to better monitor homestead
filing.This information will he kept confidemial and can only be accessed by authorized county officials.The Depanment 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
Mellor, Taylor D/Sarah'N 1`
RI Box4�
Patoka IN 47666
70
Taylor D Mellor
4901 N 200 W State Parcel Number Legal Description
PATOKA IN 47666-9041
IIIIIiiiiiiiiiiiIIIIIIllttltltrllttttl,IItttlIII 11l1.d 26-04-14-100-002.061-018 010-02061-00 PT S NW 141111.00 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
--T tOr �a\nd ��eltcr
• g Address ber and street,city,state,and ZIP code) I� Same as property address
et ell 2s ttO° .-h -cam t Q. in u�u��
•Spouse 9� First �11l�` Fri` Middle rt��\ ��//''''�� Iy� Last
aV 1 LICe.)I`
Mailing Address(Number and street,city,state.and ZIP code) f Same as property address
O t\ , 2COi,O • t 11K . 4Tli Q to o
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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 Sigtatw Date
PART 4:ADDITIONAL INFORMATION -
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