HomeMy WebLinkAboutHomestead_PurkiserCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
Stale Form 5473 (R61403)
Prescribed by the Department of Local Government Finance
place of residence the following described real property for which a Homestead Property Tax Credit is hereby claimed:
❑ I (We) owned 0' Are buying under contract
Have a beneficial interest in the entry that is liable for the property taxes on the property and that owns the property or is buying under a contract.
TACRECORDEDR 4 'M
If buying on contract, Fee Simple owner's name
Recorders office where contract is recorded Record number Page
Is Rd 0. E IRTY. OWN E CFB '? CLAIMANT
County
Tavnship
Twin di t (city, to , townshi )�
Township
County
Township
I hereby certify the above statements are true, correct and complete.
i LS
Parcel number
0098b
L s �, I Is the property i uestion
1-00-c
ftlj property ❑ Mobile Homo (I.C. 6-1. 1-7)
If any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that stfucture is used to produce income, describe the use and portion
of the property utilized to produce income.
Is Rd 0. E IRTY. OWN E CFB '? CLAIMANT
IN '6T A Ei dU NTI
Q ,.
County
Township
County
Township
I hereby certify the above statements are true, correct and complete.
Signal of claimant
"dress (number and street, city, state,
71(11-" —7k.) &-7 0
A
E
TRUE AX
'A i UE
SEiC �
HOMESTEAD1-
L
KNONipESIDENTIAE!09ssEssoWUSE'ONC � •
F7Z -:O
V At
VA 1,100%OFTIN
:5—-
P-; ; YA
Land not exceeding I one acre immediately
surrounding residential improvements.
Other land
(2)
— W *
M
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
X01-1
RA RE
Residential improvements or Annually
.
Assessed Mobile / Manufactured Home
Garage
(5)
� Mpl
III, WE
-$III
Other improvements
(6)
qW
ck W
Total improvements (line 4 through fine 6)
(7)
Total value (line 3 pits line 7)
(8)
I hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
TANDARDMEDucnoWALWWAINICE
qW 20_ Pay 2O_
Lesser of 112 Homestead
Valuation or 535.000 S
Signature of Auditor Date signed
SWF FORM 53504 OW 6101 IRFASITna FORM TS-14
APPROVED BY STATE BOARD OF"ACCOUNTS.EOG VRESCRIBFD BY TIE OIPARTMEVT OF IMaLOOVERN'NEYT FINANCE 1C 61.1-224.1
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.
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
FILED 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 G'2011 PART 1: PROPERTY INFORMATION •
Taxpayer Name Location Address
C. 3. Purkiser,Jack A/Teresa J
5592 E 475 S
GIBSON COUNTY AUDITOR
PRINCETON IN 47670
2841 p�
Jack A Purkiser IIDI�III_DIII�I�II.�IInII�IIQ�III�I�II_II��II�II II_IIIDI�I I�III ItLIIDIllItI[I III
5592E 475 S
PRINCETON IN 47670-8765
IP"I'111111'I1II1II1I1II"1Itlttl1tlllltIltt1I11FItII11FIFI1FItt State Parcel Number Legal Description
26-20-06-100-000.908-001 PT NE NW 6-3-9 2 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.
— 9 . 5 PIIA C- i NL. -,
Last
affillinii b - Li:
—
— Mailing:Address(Number andsncet;citycstate:and ZIP code)--- _ p•Same as property-address - .
11. . yla+
. 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 IN - '