HomeMy WebLinkAboutHomestead_Woolems (3) STATE FORM,.,snr:n-lot TR:ASUPSA TWIN rsIs
.VPROVEDIW Tg'30.1R11or.Nr,Y NNTS:nn 1.141_H'gnfEDD1'Tm.n1.PARTME.ST OF LOCAL COVE.%sw':111.NIKL If41.1 r- l
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 become,
Princeton,IN 47670 more beneficial.there is more incentive than c er for homastad fraud.Homestead fraud causes higher tax bills for all:therefor:.
• HliA 1344-1009 requires taxpayers wino receive the homestead standard deduction to verify that they am eligible to nceixe the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will be kept confidential and can only be accessed by authorized county officials.The Depanmert of
Local Government Finance will use this information to crate tools that will help county officials eliminate homestead thud.
PART I: PROPERTY INFORMATION-
- Taxpayer Name Location Address
Woolems, Travis L
203 S HILLCREST ST
FT BRANCH IN 47648
2503
Travis L Woolems II I�III�[III III IIIIII III IIIIIII�II_II IIIIII_II_III I II III II0110Il_I[IIL II
203 S Hillcrest
FORT BRANCH IN 47648-1404
"1111111111111111111111111111111111111111111"11111111111111"11 State Parcel Number Legal Description
26-19-18-304-000.748-026 HOLCOMB ADD 17/18PT
- - -. - --- FILE D
APR 1 6 2012
c.a.
This form MUST be returned to County Auditor AtJi� .Ne
Please do NOT send this form back with your tax payment to the county treasurer.
PART 2:TAXPAYER INFORMATION,.
Fiat Middle Last
'1c/Lv S LS u3c-rAe wS
Mailing Address(number and street.city,state.and ZIP code) ['Same as property address
Spouse Fiat Middle Last
Mailing Address(Number and street.city,slate,and ZIP code) Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (las:5 digits) Other(please specify in Pan 4 below)
I I I I I Sur
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 Since J Date
�
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDR/STANDARD DEDUCTION
sm� r� ssr3 �� i soa�
PraernLeO by tAe DepeMient d Loml Govamrt�gd F"uwnce
INSTRUCTIONS: See ieverse side Ior filing insbuctions.
FORM �� �R
HC10
— "cr� —
I M�e) V I�� A.l � 1 JN � U� I IY�L�1l/ A 1 l-CJ � certij}utmt ofl � 7� daY ot March. 20_
I(We) occupied as aa prmdpal place oi residence tlie tolbwing desaibed real property tor which a Homestead Property Tmc t is hereby daimed:
❑ �(We) o�uned ❑ Me buying urMa cantract �y/ �`h
�,` (l pUDI'iOR
�Have a benefiaal inte2st in U�e entily that is liable for the propeAy tarzes on the property and that own G�QbN�s7t�urng under a contract
tt Wy'cg om m�tracl Fee Sirt�pla owriefe name
•F'.^.� : .s: ...u�r . _� i _.._o :.
Tuvrrslrip
Tmm�p Ci5ticl (cd}: town.
H e�ry portion d Ne residanlial s6uAae a Ure IeM not e<ceedin9 one (1) aae tlmt'vnme�y surtmMs
of Ne WuGertY W6md tn O�e e�mme.
Counly
I hereby certify the above sfa�ments are We. correct arid complete.
(nurm� erd street dfY• srare. Z!P ooae)
Recard number � Pege
paperry L„J Mabile Fbme (LG Gf.f-�
ia uaed b p(oduce i�owne. tlesrnbe tha we and Pamn
20 _ Pay 20 _
Lesserof 12 HomestPad
ValuaUm or f35,OD0
� � I