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Home My WebLink AboutHomestead_Mitchell� CLAIM FOR HOMESTEAD PROPERTY TAX FORM Y AR CREDIT/STANDARD DEDUCTION HC10 State Form 5473 IRS 110-01) Prescribed by the Department of Local Government Finance INSTRUCTIONS: See reverse side for riling instructions. D. CERTIFICATION STATEMENT I (We) certify MQYri tpeqst 2A9? I March, 20 I (We) occupied as our principal place of residence the following described real property for which a Hom ad Property Tax Credit is hereby claimed: ❑ l(We)owned ❑ Are buying under contract awave a beneficial interest in the entity that is liable for the property taxes on the property and that owns the '3p2rop%rty%r11 dcontract. CONTRACT!RECORDED`�i-'."' If buying on mntract. Fee Simple owner's name Recorders office where contract is recorded Record number Page PROPERTY DESCRI?TION County Township Tam istric o", to s P1 Township I hereby certify the above statements are true, correct and complete. V Parcel number _ 0/0-0/0 0 Is the property in,Aueslion ❑ . 0L 1. �k Real property Mobile Home (I.C. b7.7 -7) If any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that Anicture is used to produce income, describe the use and portion of the property utilized to produce inixtrine. Z- I ��— -.11 4" oij :%a- PROPERTY OWNED BY CLAIMANT IN OTHER"CoUNTIFS • County Township County Township I hereby certify the above statements are true, correct and complete. Signs r of im beWd.strae 1WW7 0 � ZIP code) R a-a"' 1 -7— -TRUE-TA-X"-. ASSESSED VALUE -,-,HOMESTEAD :jhSASSESSOR USE -VALUEz AT 100 OF.TTV VALUE VAL ES J; el�L U Valuation or $6.000 Signature of Auditor Land not exceeding 1 (one) acre immediately Date signed surrounding residential improvements. Other land (2) Total land (line 1 plus line 2) (3) % Dwelling (4) Residential improvements Garage (5) ti -liU,N E RR Other improvements (6) z Total improvements (line 4 through line 6) (7) Total value (line 3 plus line 7) (8) I hereby certify the above is true, correct, and Signature of Assessor Date signed complete. Verifying action - Signature of Auditor Date signed ALLOWANCE 1W 20 _ Pay 20 Lesser of 1/2 Homestead Valuation or $6.000 Signature of Auditor Date signed StAIE FORM!MN IM-I.w1 TREASURER EO5.4711A Al./ROVED BY ST VIE BOARD OF ACCOUNTS__nn PRFAFram BY ntr DEYMT'ENT OF LOCAL G OVEPNNrAT FINANCE ICLI.I-rat 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. ® ILEA 1344-2009 requires taxpayers.who receive the homestead standard deduction to verify that they are eligible to recene the benefit and to provide additional identifying information necessary to allow county government to better monitor homestead filing.This information will he kepi confidential and can only be accessed by authorized county officials.The Department of Local Government Finance will use this information to create touts that will help county officials eliminate homestead fraud. PART 1: PROPERTY INFORMATION Taxpayer Name p a y Property Address Mitchell, Ronald L `� X7 \day /\ R Boxl99A 1 u k O Patoka IN 47666 Ronald L Mitchell R 1 Box 199 A State Parcel Number Legal Description Patoka IN 47666-9245 I I I I I I I t t t I l l l t t t l l t t t l l t t l l l l l t t l l l l l l l l l l l l L l l 11111111 26-04-23-400-001.096-0)8 010-01096-00 PT SE 231 11 1.00 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 /I671a /10r � �c�ieII *rig Address(number and street,city,state,and ZIP code) rd Same as property address 3c Nl7S \Al Spouse First Middle Last �o6Lin (I One 1'1-1 f - -eke%I Mailing Address(Number and street.city,state,and ZIP code) - Same as property address 3 5 '—7 5 W `�a*c a '1 14 7W 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 ay be liable for back taxes and substantial financial penalties. Owner 1 $moue Date PART 4:ADDITIONAL INFORMATION - •