HomeMy WebLinkAboutHomestead_Brown (17) MATE FORM TA1MIR2/+wl TREASUEUA FORM IIA
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APPROVED BY MATE M-RUK Arn Al S.Env PALSCIIUED BY Till OEYMTMVr OF U I GOVERNMENT FINANCE IC a-1.t--r-RI
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 e'er for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
fir--.
FIFA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to reecho the
�7 benefit and to orositi additional identifying inn and n my rev to allow county government to better monitor homestead
1t11jL-J filings.This information will he LLtu crnGiemial and can only h accessed by authorised county oflici.ds.The Ikpannsnn of
Local Government Finance will Ire this information to create tools that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION
APR 0 7 P010 Taxpayer Name Property Address
_ �j�� Brown, Brian
Q'1 /e/.��y ° 206 N Church
GIBSON COUNTY AUDITOR Fort Branch IN 47648
2822
Brian Brown
206 N Chruch St State Parcel Number Le°al Description
FORT BRANCH IN 47648-1104
1t1n11nr1r1lur1u11u1rur11nrl1l1uulu 11lrnrllnlrlrrl 26-19-18-301-000.634-026 011-00634-00 PT NW SW I&3-10.33 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
tall Lp Q. OW (\
Ong Address(number and street,city,state,and ZIP code) 74.Same as property address
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) [] Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Pan 4 below)
Sane _
- _
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 Signature Date
PART 4:ADDITIONAL INFORMATION
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CLAIM FOR HOMESTEAD PROPERTY TAX
'' CREDIT/STANDARD DEDUCTION
� Stale Form 5473 (R6 / 403J
Prescri6ed by the DeDartment of Local Govemment Finance
INSTRUCTIONS: See reverse side /orlilinq insfmcfions.
� ( FORM YEAR
HC10
�
� M�e) certiry lhat on the 1sl day o( March, 20_
I(We) occupied as our principal lace of residence the following described real property for which a Homestead Property�t�y daimed:
L�(We) owned ❑ Fve buying under contract GIBSON COUNTY AUDITOR
� Have a benefidal interest in the entity that is liable for the pmperty taxes on the pmperty and Uiat owns the property or is buying under a wnVaG.
I( buyug an contract, Fee SimD�e ownefs name
olfica whera wnVaIX i5 recorded
County
Parcel number
d (l b�(
H any portion o11he resid
ot the properry utilized b
Toxnship
Legal description
fown.
Is the Droperty in
Record number � Page
i- b 0 I I �w o�oa�M ❑�.7obite Hwno (l.C. 61. f-n
sWCture w the Wnd not axcaeding one �1 � arre lhal immediately surtounds Nat sW re is used lo Droduce incwne, describe �he usa and portion
ice income.
9 ry� � � '.-Ek ^`$ s€.�=it.� � ��'w� �i Y "''t� - ... � ��t � � .
-� y��. = TRUETAX a3s A$SESSED VACUE �aHOMESTEAD� �NON�2ESIDENTIAL •
�-,�`'�'�-.:i ASSESSOR USE ONLY '�-' '+ y� ;,, .,�ypLUE�S,�,y�''� �AT�i700Ye'OF�ITV� ° VAL�IEx ���,��yVALUE� ��
. 'i3g. . -. ri-V7.�i3�'i:t?4;%'�':. ��s,`�-�.41{i�L- .��.. '�� 4 _ .�
Land not exceeding 1(are) acre immediately c ��w�,'' �"ry��"��,�,'!y. .
suvounding residential improvemenLs. (� � ��`' �'�c'` j �fl
.?�:,�r?'_ ,.vr...
���-; . �� � ' _
mK � ,
Otherland (z) �
����
Tdal land (line 1 plus line 2) (3)
Dwelling (4) ����b'=�����,�. i ,.' �:��
Residentlal improvemenLS or Mnually ��"'"���"���''"�"'�y'���
Assessed Mahile / Manufaclured Home Gara e ����� r.- kt� �
9 (5) m� �' ,'�u�s . s� �'
7 '"�-"�: �i
Other improvements (6) �: �`- =' "0'^�
�?e�He.
Tdal improvements (line 4 through line 6) (�)
Tdal value (line 3 plus line � (g)
I hereby certi(y Uie above is We, corred, and Signature ofAssessor Date signed
complete.
Verifying aclion - Signature oflwdilar Dale signed