HomeMy WebLinkAboutHomestead_Nelson F SHAT£FORM 53564(RJrita) TIFASw FORM •IA
APPROVED BY STATE BOARner ACCOUNTS.HW PRESCRIBED BY TEEnsPARTME\i OF LOCAL GOVERWENT FINANCE IC 61.1-23A1
•
• Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N. Main Street Individuals and married couples are limited to one homestead standard deduction-As the receipt of this deduction becomes
Princeton,IN 47670 more beneficial,there is more incentive than ever for homestead fraud.Homestead fraud causes higher tax bills for all;therefore,
® F I I - F, HEA 1344-2009 and provide requires taxpayers identifying win receive the anon ec say to allow con to government that they are eligible or homestead
the
benefit and to prmide additional identifiing infomiation necessary to allow'arnmry grnemment to better monitor homesteod
filings.This information will be kept confidential and can only be accessed by authorized county officials.The Department of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
APR 2 5 2011 PART l: PROPERTY INFORMATION
' Taxpayer Name Location Address
C - f�—� Nelson, Jack E/ Betty J
GIBSON COUNTY AUDITOR 8388E 900 S
ELBERFELD IN 47613
8987 i i II i i IIII i Ili i f i f l f i i II I ji Ili i
Jack E/Betty J Nelson IIII I�I11_ul�IIlilluMIillll I�DIIInnII II�niIDIIlii_III�IIII IIIIIII_�II�IILIII ul IIII
8388E 900 S
Buckskin IN 47647
State Parcel Number Legal Description
26-20-28-200-000.613-001/ PT NE NE 28-3-9 2.25 AC 0-19
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.
_:-F ----_.-_ ___ ______.._ ._PARL2:TAXPAYER INFORM ATION --______ __ _!Qa.:�:1 — —; _ __ .. . - First - . - Middle Last
Jar- K EC D i n iso n
•
Mailing Address(number and street,city,state,and ZIP code) - El Same as property address
c. 83 53 6 9oo S S1bcr- _,ld h. 47 76%]
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[D Number (last 5 digits) Other(please specify in Part 4 below)
I I I I I= I' I I I suet
=-'----
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 .
PART 4: ADDITIONAL INFORMATION
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Form 5473 (R4 / 8-00)
INSTRUCTIONS: See reverse side for filing instructions.
0 YEAR
SEP 17 2001
1 IWO ' /f GIB763M"gbhl ' H6'1'9t day of March, 20_
1 i(we) occuo d as our principal place of residence the following described real property for which a Homestead Property Ta(Credit is hereby claimed:
M I (We) owned ❑ Are buying under contract
Wave 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.
_NTRK'LRECORD
It buying on wntract, Fee Simple ovrnefs name
Recorders office where contract is recorded Record number Page
ASSESSOR
AMENTRUS—Mi W
P
County Township
County
County
Township
Taxing district (city, town. township)
'255 (number and street sfa ZIP code)
- � � (I A
Legaidesaip
--�UL
X:
U
Land not exceeding 1 (one) acre immediately
If any portion of the residential structure or the land not exceeding we (1) am that immediately surrounds that structure is used to produce income, describe the use and portion
of the property utilized to produce income.
0 0
ASSESSOR
AMENTRUS—Mi W
P
County Township
County
Township
I hereby certify the above statements are true, correct and complete.
g ture 0t claimant
'255 (number and street sfa ZIP code)
- � � (I A
ASSESSOR
AMENTRUS—Mi W
P
-jrUF.T ni'
TiS - ffSEDVZUTQE
iHOMESTEAD
ZQF
N W SIDE
'ZNI�6�0�
RT
X:
U
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
Other land
(2)
WAR
Total land (line I plus line 2)
(3)
Dwelling
(4)
Residential improvements
Garage
(5)
Tzygg
Other improvements
(6)
Total improvements (fine 4 through line 6)
(7)
Total value (fine 3 plus line 7)
(a)
I hereby certify the above is true, correct, and
Signature ofAssessor
Date signed
complete.
Verifying action - Signature of Auditor
I
Date signed
I
'DE Ucppm!
20 _ Pay 20 —
Lesser of 12 Homestead
1
$
Valuation or $6.000
Signature of Auditor
Date signed