HomeMy WebLinkAboutHomestead_Hall (5) STAR I ORM,M4403 r s-lil IR ASURLR/ORM ES-IA
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r Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS.
101 N. Main Street Indisiduals and married couples are limited to one homes:etld standard deduction.As the receipt of this deduction become,
Princeton,IN 47670 more beneficial.there is more incentive than ever for homat•ad fraud.Homestead fraud causes higher my bills for all:therefore,
144-2009 reclaims taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
clii nd to provide additional identifying information necessary to allow county government to better monitor homestead
fi 'r s hisin-formation will be kept con&kntial and an only be accessed by authorized county ollicials.1 hhe Department of
YYYY//L cal Government Finance will'u a this information to crape tool::hat will help count otFeials elimirnte homestead Ilaud.
PART l: PROPERTY INFORMATION
1� Taxpayer Name Location Address
_ P‘‘ 1 Hall, Jeremy W
C,. -C.1 V Ft 105 E MULBERRY ST
7087 G\BSON C 103 " FFpUO\Z° FT BRANCH IN 47648
Jeremy W Hall IIIIIIII_IIII III IIIII,IIIIII IIIIIIIII'III III]IllII�IIIIIII I II IIIIIIIII�IIIIII II
105 E Mulberry
Fort Branch IN 47648-1517
11111111111111"11111111111111111111111111"11"11111111"11111 State Parcel Number Legal Description
26-18-24-202-000.940-026 PT NE 24 311 .50 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:.TA.CPAYER.INFORDIATIONt •____
- _ _
ter I First Middle Last
N. Jed'e c ,f_,-c T7/ - //
Mailing Address(number and street ity,stare,and ZIP code) El Same as property addross
/DCA. -7,7d,Aere _C-7L_ r7_Bet? �ti rte/ 9 7%I
.
Spouse First Middle Last
Mailing Address(Number and sweet city,state,and ZIP code) El Same as property address
Social Security Number(last 5 digits) Driseds License/State ED Number (last 5 digis) Other(please specify in Pan 4 below)
, I I I I I I I stale
. 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 maybe liable for back taxes and substantial financial penalties.
Owner I Si,. ya _ Dare
ip
( )
PART-4:ADDITIONAL INFORMATION
-
N� CLAIM FOR HOMESTEAD PROPERTY TAX FORM Y�
" °' ' CREDIT/STANDARD DEDUCTION
; � Slate Fwm 5473 (R4 / 8-00) HC10
u�.
INSTRUCTIONS: See reverse side /orfilirg insWC6ons.
iv -� -4�
�=�'�'�.-��'�__�;t;.:�'�i�.'�-'..�°?�M,�`�,�'���.� ER1IF.IC,A_710N�,57"ATEMENT�a�,.....�',.,,,,-�,7�� ``��'�K����_.'03�
I(We) certify that on lhe 1st day of March, 20_
I(VJe) ocwpied s ur principal pla of residence the follmving desuibed real property (or which a Homestead Property Tac Credit is hereby daimed:
.�I (We) owned ❑ Are buying under contraC
a beneficial interest in the entity that is liable for Ihe property taxes on the praperty and that owns the properry or is buying under a contraG.
If buyirg on contraU Fee Simple ownefs reme
Remrdefs otfice where contract is recorded
RecorC�numEer � Page
.��:;ts..._��`��-,:".�s. �i"�a,�r?���.��.�,Y k �„PROPERTY�DE_5_CRIP�TION_�j`��,a;:_az". ;` , � .= ... w`�, , '
Counry Tamship Tacing Cistricl (ciry, fown. tawnship)
Parcel number Legai desaipfio -- _ I ,
If any pwtian ol the residendal sW Gure or the land irot ex g one (1) ave that immediatey surtounds Nat sWUure is useA to pmduce inmme, desui�e the use aM portion
of the properry utilizetl lo proCUce income. � � . � - �
. -• ""'_�__
�,_„i ,`��,�,��.���"�+`��..+��.'�,�.�PROP,ERT'laO,WNED�B CY_�__�L_.A_IMANT�IN?OTFiER,COUNjIESc-7.s,�-- -�,�.- -,,�..,�� *„.� .r-�"r�,,.'s.'�7,-�.,,,,�;_ �-
Caunty - Twvnship . County . . Toxnship
I hereby ceNfy the above statements are We, wrreC and complete. i9nature oi �Ja' ant
� .
��ess (num6u and street dty; state. ZIP wde) �� �
-���C." ,f"�r",'y�.���.�^�'�"��^;�`.�%�'�STANDARU°DEDUCTIONt,4Ll:OWANCE��4„-�'��''����.f � "�""
� . � � � �'r. '�` ��' �" : 7 ' '�? :' � 3 . �. _ : r �
20 _ Pay 20 _
Lesser of 12 Homestead
Valuation or 56,000 $
SignaWre olAUOita Date signeE