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HomeMy WebLinkAboutHomestead_MinnisCLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR CREDIT /STANDARD DEDUCTION HC10 State Form 5473 (R614-03) Prescribed by the Department of Local Govemment Finance INSTRUCTIONS: See reverse side for filing instructions_ I (We) `�i.certify,lhat ;ori theflst day of March, 20 (We) occupied as our pnnci I place of residence the following described real property for which-a Homestead Property.Tax Credit is hereby daimed: ❑ I (We) owned ❑ Are buying under contract 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. ii4:y'jdC� 3 : c"_ g.•- �� `t.'>��6F'��rsr`��.�?�.'.ii`- NTRACT. 'RECORDED�Y�`�,<",'r'�"�- .?���fi If buying on contract, Fee Supple owners name Recorders office where contract is recorded Record number Page ......�i�a`. County Township Taring district (city, town, township) P tier D O _ DOU L al d dour^ n � ? `4) / Is the prop Oin eal -.'-le Land not exceeding 1 (one) acre immediately property ❑ Mobile Home (I.C. 61.1 -7) If any portion of the residential structure or the land not exceeding one (1) acre that iimmlmepia(eiy s that structure is used to produce income. describe the use and portion of the property ut&ed to produce income. / l!J aG -4 i` 3- /oa -000. G9�4 Q/00 County Ta nship I hereby certify the above statements are true, correct and complete. street, city, stale, County claimant 1i5r'h4`�"i;M.eS SSESSORUSEONLY'''�i ' £-q.` TRUETAX arASSESSEDVALUE. HOMESTEAD." 4-,+�VAL'UE y tNON= RESIDENTIAL t? �.a'r'uTfx:_VALUE. .s+^`g• R„+S g>'�'t S +:.' �1' _;?? ' e ,, VALUE ': ATz100%a__OFWYT11I1 -.'-le Land not exceeding 1 (one) acre immediately 3de surrounding residential improvements. O "S Other land (2) ml 'l'` . - 3 ra Vi i= J� . .1 5� Total land (line I plus line 2) (3) Dwelling (4) M 3.'�ii'irfF ft 'fvi+ 4�rn,�ru 14 Residential improvements or Annualty rr. at�s'd Assessed Mobile I Manufactured Home Garage (5) � -Nra Other improvements (6) y Yi%Z::acZ5'sY Total improvements (line 4 through line 6) (7) Trial value (line 3 pits line 7) (S) 1 hereby certify the above is true, correct, and Signature of Assessor Date signed complete. Verifying action - Signature of Auditor Date signed , STANDARD .DEDUCTI0WALLOWANCEx"4P?""?�" � w.'v- r�'uz� Y'.-'�.an�i f-?R_ f?�`•.eryr��.�.n s.-:r 20_Pay 20_ Lesser of 112 Homestead :Is Valuation or 535.000 Signature of Auditor r \ Date signed ra ' 0 STATE FORM!)!MIR-r?NM THE SULEX W0.41IA AP/ROVED BY tr ATE MP/ADM ACCOUNTS/1n. PR/SCRIBED BY nil DEPARMEYf Q LOCAL CAN21l.VNE).'T FQ:A\LE IC el.I-21-I.1 Gibson County Auditor 101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS 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 ever for homestead fraud.Homestead fraud causes higher tax bills for all:therefore. • HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the benefit and to provide additional identifying information rleceseary to allow county government to better monitor homestead filing.This information will be kept confidential and can only he accessed by authorized county officials.The Department of Local Government Finance will Inc this information to create tools that will help county officials eliminate homestead fraud. PART 1: PROPERTY LNFORMATION Taxpayer Name Property Address Minnis, Raymond 4115 N 200 W Patoka IN 47666 72 Raymond Minnis 4115 N 200 W State Parcel Number Legal Description PATOKA IN 47666-9033 1111111111111111ell l l i l l l t l l l l l'I I I t r t I I l t t l I I t I t I1 l I l t r l 26-04-23-100-000.694-018 010-00694-00 PT S NW 23-1-11 1.708 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 OwnerII� First Middle Last rr Ong Address(number and street.city,state,and ZIP code) © Same as property address Spouse First Middle Last • Mailing Address(Number and street,city,state,and ZIP code) n Same as property address Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Pan 4 below) Sox 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 5,..; Signature Date Telephone PART 4:ADDITIONAL INFORMATION •