HomeMy WebLinkAboutHomestead_Roettgerae ny
era CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (R2 / 5 -92)
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INSTRUCTIONS: See reverse side for filing instructions.
FORM YEAR
HC10
FIL
CERTIFICATION STATEMENT
1 (We) certify t on [he 1s da March 19
�) occupied as ur principal. place of residence the following de cri ed real property for which a Homesiea ropertyedi hereb ai d:
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,_. . (We) owned ❑ Are buying under contract - - ; _ -
❑ Have 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.
CONTRACT RECORDED
If buying on contract; Fee Simple owner's name
Recorders office where contract is recorded Record number Page
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES -
PROPERTY DESCRIPTION
County
Township
Taxing district (city, town, township)
Par el nu ben
Legal descriptio
/
It any portion of the residential structure or the land not exc
of the property utilized to produce income.
ing one (1) acre that immediately surrounds that structure is use6 to produce income, escn a the use and portion
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES -
County
Township
County
Township
•eby certify the above statements are true, correct and complete.
Sig re oI claimant
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
ddres `umber and street, city, state, ZIP -do)
L 1
STANDARD DEDUCTION ALLOWANCE
19 Pay 19
Lesser of 1/2 Homestead
Valuation or $2,000 S
Signature of Auditor. Date signed
i
94
ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON - RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
"
Otherland
(2)
Total land (line I plus line 2)
(3)
Residential improvements
Dwelling
(4)
Garage
(S)
- -
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 pits line 7)
(g)
1 hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
VentVing action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19 Pay 19
Lesser of 1/2 Homestead
Valuation or $2,000 S
Signature of Auditor. Date signed
i
94
r STATE FORM!!a OCI.NI WS.ASURDR FORM 711A
.APPROVED m'SIAM bHRD M ACC(ICNT(.:0,4 Ptr9[RIDED BYrllrnErA0.n e.rOrtu'AItnrtrsMCNT FTNcr ICVI.I-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 standanl deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than tier for homestead fraud Homestead fraud causes higher tat bills for all:therefore.
• . HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to creche the
benefit and to provide additional identifying information necessary to allow county goverment to better monitor homestead
tiling,.This information will he kept mnlidlmtial and can only he aerrxed by authorized roomy officials.The Ikpanment of
I.ocal Government Finance will use this information to create t ols that will help county officials eliminate lwmcstcad fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Roettger, Dixie Lee Life Est/Larry I�
WiraTr. O
R3 Box 130 A
Oakland City IN 47660
8656
Dixie L Roettger
6737 S 950 E State Parcel Number Legal Description
Oakland City IN 47660-7730
'IItIIItIrllltt lull lltll ttt alt trl rt alt ll ��r�trt���trr� 26-20-15-200-000.999-001 001-00999-00 PTE NE 15-3-91 AC
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PART 2: TAXPAYER INFORMATION
Owner I Fiit Middle Last
LI Ye, L rYp�e 49e .
One Address(number and street,city,state,and ZIP code) -- — — - — - Ir`Same its prop& ? dress.--- -- ---
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as property address
Social Security Number(last 5 digits) DrisxY5 License/State ID Number (last 5 digits) Other(please specify in Pan 4 below)
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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.
Own I Signature Date
.
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