HomeMy WebLinkAboutHomestead_WaldenCLAIM FOR HOMESTEAD PROPERTY TAX F—YEAR
CREDIT/STANDARD DEDUCTION
State Ferro 5473 (R7 / 5-W Fdti
Prescribed by the Departniard of L=l Governrnent F6
INSTRUC nONS: Sew reverse side for filing instructions. N U V 9 Zu0j
I (We) -A / (/ � 4 1 &,V C — 20_
1 (We)occtjpied as � principal place of residence the following described real property for which . Hanes =W,.' ere
I (We) awned ❑ Are buying under contract
Have a beneficial interest in the entity that is liable for the property taxes an the property and that owns the property or is buying under a contrad.
- COMRACT RECORDD, , P , 1 , ,
If buying an contract, Fee Sirroe senses name
Fix; order!s dice wlee contradis minded Record number Page
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'-PROPERTY OESCRIPIWt:,''
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County
Canty
Township
7kaing di Ict
ghpuse, (number and sliest '7
FIV 9, 0 0
Date signed
0 olx_
Land not exceeding I (one) am immediately
M=
10&e:2Z%e_0
Parcel number
Legal descdpbm Is the property'
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;P. r prop erly rty
kou )a Home (W. &1.1 -7)
tf arry ofthe residential sbLchrawdmlaridnote=eec&Vone(I)c
used to produce describe the use and portion
ol the wdir®d to Prod .
Tdal land (line 1.pka fins 2)
(3)
,f,,l 100-
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County
Township
I hereby certify the above statements are true, coned and complete.
3 nt--
ghpuse, (number and sliest '7
FIV 9, 0 0
ASSESSOR USE 6hy
TRUEMAX
AWFSSWV ALUE
T TV'
HOWESTEAD�
�r'�",VALUE -7 1�z:
Valuation or 535,000
$
Signature of &xftor
Date signed
Land not exceeding I (one) am immediately
N
warrounding residential improvements.
Other land
(2)
Tdal land (line 1.pka fins 2)
(3)
Dwelling
(4)
Residential rmpraveraents or Annually
Garage
(5)
Assessed Mobile Manffacbxred 1 lone
Other improvements
(6j
Total improvements (fore 4 thmeo liner 6)
(T)
Total value (fine 3 pks fine 7)
(8)
I hereby certify the above is true, comscL and
Signature of Assessor,
Date signed
complete.
vardying Boom - sunatury of AAtw
Deft so
11%. a'AP. 1s11' N
%W 20 Pay 20_
Lesser of 12 Homestead
Valuation or 535,000
$
Signature of &xftor
Date signed
STATE FOR\I!N.1R_1 HMI t1FAAltIx FORM T11A
AI/ROVED BY STATE BOWL Of MTOI'.\Ti.!ow PR StitIDFD BY TIM DEPAR•EYI OF LOYAL CriOVELNMENE FINASCE MVI.1-L'-,.I
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to One homestead sandard deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than e'er for homestead fraud.limes—lead fraud causes higher tat bills for all:therefore.
0 HEA 1344-20cc requires taxpayers who receipt the homestead standard deduction to verify that they are eligible to reecho the
benefit and to provide additional identifyin_information necessary to allow county government to better monitor homesead
filings.This information will he kepi cant:dentinl and can only be accessed by authorized county officials.The Dcpanmatl 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
_ Walden, Rick
2200 Lake RD
Princeton IN 47670
397
Rick Walden
R1 BOX 46 State Parcel Number Lecal Description
PATOKA IN 47666-9039
Midi I I III I I 1 1 1 1 1 1 I I I I III III I 26-04-14-400-000.699-018 010-00699-00 PT SE 14-1-11 8.40 AC
t tF tut t tut tut nt t tt t t Fttt n tF r tar
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PART 2: TAXPAYER INFORMATION
Owner I
Rtei First Middle {���� ,( Last
ion o Address(number and strac,city,state.and ZIP code) - -- — --. — — m prcper1 nddress _ -_ __ — —
&G 7072 Sao W - I74'b /UaooW
S•-'tae First( Middle Last
Mailing Address(Number and street,city.state.and ZIP code) ❑ Same as property address
Social Security Number(last 5 digits) Driyn's License/State ID Number (last 5 digits) Other(please specify in Pan 4 below)
sou
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 ',nature Date
)
PART 4: ADDITIONAL INFORMATION
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