HomeMy WebLinkAboutHomestead_Braselton (2)CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
r State Form 5473 (R2 / 5-92)
,s INSTRUCTIONS: See reverse side for (ling instructions.
FORM
HC10
FILJ
C1T
WE
YEAR
CERTIFICATION STAT,54ENT
JAN 1
I (We) e i at on the 1 st day of March, 19_
1 (We) occupied as our principal place of residence the following described real property for which a Homestead operty Tax C dit ereby im
❑ 1 (We) owned ❑ Are buying under contract GIBSON CCOUNTyp��r��Tr�p
❑ 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 11r1DW Rr
CONTRACT RECORDED
If buying on contract, Fee Simple owners name
Recorders office where contract is recorded
Record number
Page
PROPERTY DESCRIPTION
-
Co
Township
T lri , r JP)
Parcel number -
o5 -D "a0
Legaldescripti
f
I
CT/
If any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that structure is used to produce income, describe the use and portion of
the property utilized to produce income.
-a - d
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
County
Township
County
Township
®,ereby certify the above statements are true, correct
and complete.
Signature of a "Mani
/Jal. n -
l- - �'--c—
Add r
(num arM (reef, city, state, ZIP code)
/e.l-
ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON - RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Otherland
(2)
Total land (line I plus line 2)
(3)
Residential improvements
Dwelling
(4)
Garage
(5)
Other improvements
(6)
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
complete.
Signature of Assesor
Date signed
Verifying action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19_ Pay 19
Lesser of 1/2 Homestead
Valuation or $2,000
S
Sig re of Auditor
p
Date signed
D i as -a
• stA1L FORM!MIA iR:(sJt TREASUEOI/ORMIIA
.ArPROVEn BY 4fAIE BOARD OF Afn*NTS.20, PRFVEtUBFD BY 1111 DEPARTMENT OF LOCA1 t)v R.4MFfi FINANCE IC LI.1-124.1
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
�F y more 344-200 there r more incentive who receive ever for fraud.do deduction fraud causes higher lac bills le all:therefore.
�fOpli1 HEA 1344 vial, here is ore rove ive than
the homestead homes[a standard Homestead
m verify that they are biils for
t all:
the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
flings.This information will he kept confidential and can only be accessed by authorized county o icials.The Depanment of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
APR 1 4 ZUiU PART 1: PROPERTY INFORMATION
Taxpaver Name ' pertv Address
2jr Braselton, Chester P Roslyn A w l l -t- h
(�J 7 Ivor h
— GIBSON COUNTY AUDITOR It
Owensvillc IN 47665
2170
Chester P Braselton
P O BOX 105 State Parcel Number Legal Description
OWENSVILLE IN 47665-0105
II l ll II I l it Ills I I II I I ill 26-17-01-400-004.209-021 005-04209-00 PT NE SE 1312.34 AC
_ _ ___ tn urr ur nrrr nntt uutuu __ D-16-20 _ _ - — -.
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
•g Address(number and street,city,state,and ZIP code) • Same os ro
dd
Spouse First Middle Last
(Sale) , /
Mailing Addr (Number and street,city,state.and ZIP code) [] Same as property address
4- & A iIP S (/we,1t:4-Ci&4 'A7�G s G s-9-4-v-7064/a,
-- --
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 Sicnattue Date