HomeMy WebLinkAboutHomestead_Daywalt :SIAM r ORM!)WIr`r.wl TREASURES FORM—tA
.Arrrr rn BY AR[BrxROOFAMENTS'_on PRISCPMm BY nit DEPARTMENT OF LOCAL r Wtt.MMrWr FINANCE ICH.I-r-si
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 ever for homestead fraud.Homestead fraud causes higher tat bills for all:therefore.
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verity that they are eligible to teethe the
benefit and to provide additional identify-inn information necessary to allow county government to better monitor homestead
filing+.this information will he Lepl confidential and can only be accessed by authorized county officials.The Depanntcnt of
Local Government Finance will use this information to create exits that will help many officials eliminate homestead tmud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Daywalt, Steve A
704 Roosevelt Drive
Fort Branch IN 47648
6716 _ _ _ _ _ . _ _
Steve A Daywalt
704 N Roosevelt Dr State Parcel Number Leaal Description
FORT BRANCH IN 47648-9774
' II I II III I II I I III ( III I 26-18-13-101-001.122-026011-01122-00 CANDLELIGHT VILLAGE 24
t o tut ut n n t t n ut nt t o nn n nt 0-27
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
Ve- ,+te--n Oct yWwit
•ng Address(number and street.city,state,and ZIP code) — — - - - -- Etcame 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)
5=
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
•
�; CLAIM FOR HOMESTEAD PROPERTY TAX
'' CREDIT/STANDARD DEDUCTION
� S�a�e Form 5473 (R6 / 4-03) �
Prescn6ed Dy the Department of Local Govemment Finance
INSTRUCTIONS: See reJcrse side Ior Iiling fns(niclions. �
i
I VV�r FORM YEAR
� M�e) certi at on t da Mar 0
I(W�upied as our principal place of residence the foll ' descdbed real property for which a Homeste ����� Cr� �� ed
U
(We) owned ❑ Are buying under contract
Have a benefidal interest in the entity that is liable (or ihe property taxes on the property and that owns Ihe property or is buying under a contraG.
If huying om m�traq, Fee Simpie ownets name
Caunry
conVad is recwded
5.�[�+� y,� ��;i��?� yr��
��.1€�-.. ..`SCS !��Y
Tavnship
Parcel numher I
Q//-41-/�-
I( any poNiw� of Ihe resiEenlial structure w the
of Ne pro0erty uti¢ed tn produce income.
t etFceeding one (1) axf!
�i�������
Record number � Page
, . I Is Ihe property in question:
'- � �i �a a
V �'� D P rtY ❑�b➢e Homo (I.Q 61J-�
imme0iatety surrountls that sWGUre is used b produce inmme, desuiba Ne use antl portion
a �i
�;�'vc.-�: ��?���s"rc,. -'�'T`�'"p��.PROPER'fY;OV1INED���81!:CL'AIM,4NTIN�OTHER�'COUNTIESv�.,''�_`.„`"�.'�-'�r�`-�„�_-''�� -`-.���"�'5.�-�5�_Y�
County Twvnship County Tavnship
I hereby certify the above statements are true, coned and camplete. n re ol daimant
�,.�, a .
' ress (number and s4eef, city, uafe, ZfP code)
=�?�.e.�i'..'�'t�'�.'�«=�. `�.�F.y%�.'�`iv��.'�'t�'�`,�`'-.-'•'�STANDARD:DEDUCTIONALL`OVJAMCE,�'.,w�s'u''Zxf<>4:'�'.'�"'�'s+"��35i''�`dv'.�$. '�e2-�'s2."�.«.�.'Z?�
� _ : _:-
20_Pay20_
Lesser of 112 Homestead g
vaivauon w E35.000
Sgnatura of Auddor ' Date signed