HomeMy WebLinkAboutHomestead_Helsley (2) it
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S Gibson County Auditor ThIPORTANT-NOTICE TO HOMESTEAD PROPERTY OWNERS.
101 N.Main Street
Ind'.Ulna's and married couples arc limited to ntlt honws:ead standard deduction.As the receipt of this deduction becomes
Princeton,IN 47670 more beneficial.there is more ins ntise than ever for hamestcld fraud.Homestead fraud cauws higher sax bills for all:therefore.
F I L E ID II EA 1344-2009 requires taxpayer who scot,,/the homestead standard deduction to verify that they are eligible to revels,/the
Muth and to punt&additional identifying information necessary to allow county government to better monitor homestead
filings.This information will be kept confdential and can only be accessed by authorized county officials.The Department of
Local Government Finance will use this information to create tool,that will help counts'officials eliminate homestead wand.
JUL 2 2012 PART l:PROPERTY INFORMATION
Taxpayer Name Location Address 0
C. .r Helsley, Kerry L
105 E DOERNER RD-LOT 26
GIBSON COUNTY AUDITOR LYNNVILLE IN 47619
9353
Kerry L Helsley
1 1101 ill I-II ill i oiiii iI II Mil I Illll l lii1 III II[ii l lit El 1111111111.111111 ii
12991 E 1025 S
Oakland City IN 47660-7801
I1"II'Illrrllllllllllllrlrliliillllllltlillrrllllltll'IIIIIlI'il State Parcel Number Legal Description
26-21-32-303-700389-001 BLDG ON LSD GROUND LYNNVILLE
PARK LOT 26
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.
'1 i-.
r I First L Middle ge. Last
Mailing Address(number and street,city.state.and ZIP code) 0 Same as property address
420 99/ — f i°0167:150(Ifil
Spouse . First Middle Last
Al It
Mailing Addles(Number and street.city,state.and ZIP code) El Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
_I__ I._—I r -- I-0--I----- -- --I— Sae --
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 Siglaturx W24.____ gt�jd ',T
PART 4:ADDITIONAL INFORMATION
CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDIT /STANDARD DEDUCTION HC10
t State Form 5473 (RS 1 10-01)
uu Prescribed by the Department of Local Government Finance
T9
INSTRUCTIONS: See reverse side for filing instructions.
I (We) f-N\ 'ck1-1,A -L o., , certify A9 A 11�t March, 20_
1 (We) occupied as our pn' n I place of residence the following Qcribed real property for which a Homestead Property Tax Credit is hereby imed:
❑ 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, " @3s; buyirl�.widei a contract.
NTRACT.'RECORDED';a " asr-- six- '"`- -'
If buying on contract, Fee Simple owners name
Recorders office where contract is recorded Record number Page
a
_ to ?�iSuc'lir"£
�sis�. ?PROP ,ERT,YrUESCRIP.TION�`1�'�+"��.
County
Township
Si ure of claim
Taring district (city, town, township)
ar I
umbe 77'��
-OV
Leg es "p n
ry.,� VALUE d
Is the property in question:
I
(1)1
-j
❑ Real property ❑ Mobile Home (I.C. 6.1.1 -7)
If any portion of the residenflal structure or the land not es
7&ne (1) acre that immediately surrounds that structure is used to produce income, describe the use and potion
of the property util¢ed to produce income.
- d- U3 -
-Gtr
r N§0-.—
County Township
County Township
I hereby certify the aaabboevee are true, correct
Si ure of claim
a(n
�statem�[eentts� tand {cAoompllete.
s %DC W ; lJ Z ))d WAIF
66 0
(1
`/153ESSOR�USE ONLY" t?'
�"TRUETAX Y'4F
ASSESSED VALUE
-t
HOMESTEAM
'NON ESIDENTIAL AWNS
,. ar`• .v
. '
.mss.?VALUEy'
sAT100 %OF"TT'V
xr- 1VALUE
.,..r
ry.,� VALUE d
Land not exceeding 1 (one) acre immediately
(1)1
'5kb•�^i *.'^
surrounding residential improvements.
Other land
2
�x'- w i
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
Residential improvements
Garage
(5)
Other improvements
(6)�f"'+.'f
-:;�,
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(6)
1 hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
-STANDARp.DEDUCTION ALLOWANCE
20 _ Pay 20 _
Lesser of 1/2 Homestead
Valuation or $6,000 � �� �y /�1 $
W
Signature of Auditor AI ,L ` Date signed