Homestead_Williams (5)CLAIM FOR HOMESTEAD PROPERTY TAX
CREDITISTANDARD DEDUCTION
State Form 5473 (R6/4-03)
Prescnbed by the Department of Local Government Financ-
INSTRUCTIONS See reverse side for filing instri,clio,".
I
_ "CERTIFICATION STATEMENT
1 t I FORM YEAR
I(We) V certify thatjon NhAstl,Y200PAarch. 20
I (We) occupied as our principal P& of residence the following described real property for which a Homestead Pro erty Tax Credit is hereby claimed,
El I (We) owned ❑ Are buying under contract lair"
0-
Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns thGIB4GNyGOUbiTyViOAtBIWORontract.
f: -01
CONTRACT-RECORDED
If buying on contract, Fee Simple owners name
Recorders office where contract is recorded Record number Page
sj-:—'__. :PROPERTY DESCRIPTION
Coup it)
Township
Township
Taring district (city, town, tow to)
Parcel number
Leg 4qescnptjon
Is the propyR,.,.e,,property 1 . a n,*
0 0 / - Dr) -1� (Da—m
I V+ F a I S 3
6C Mobile Homo (I.C. 61.1 -7)
If any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that structure is used to produce incorne, describe the use ana Portion
of the Property utilized to produce income.
-1 - �,
0 ROP E kTY OWNED BY CLAIMANT IN. OTH ER'C OU NTIES 1 e.e
County
Township
County
Township
I hereby certify the above statements are true, correct and complete.
Sg at re of claimant
valuation or $35.000
Address (number and street, city, state, ZIP code) I
ffiPt,2.5&X 12X��44 04/cid e,'t:x —1:-Al. V74,1 0
oat
efftr) I—QS
LY
TRUE TAX
ASSESSED VALUE
":HOMESTEAD
'VALUE,
NON'RES-16ENTIAL'
VALUE
A T100%_OF.TTV-
VALUE
Land not exceeding 1 (one) acrelmmediately
surrounding residential improvements.
(1)
a
Other land
(2)
Total land (fine I plus line 2)
(3)
Residential improvements or Annually
Dwelling
(4)
Assessed Mobile I Manufactured Home
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
Total value (line 3 pits line 7)
(8)
1 hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
STANDARD. DEDUCTION ALLOWANCE
W 20 Pay 20
Lesser of 112 Homestead
valuation or $35.000
SignalroyAbditor
q I
I 0A
oat
efftr) I—QS
C1
STATE FORM 53500471.1/9-10) ., TREASURER FORM TS-IA
APPROVED BY STATE BOARD OF COUNTS.20N PRESCRIBED BY THE OFPARFMENT OF LOCAL OCATRNMENT FINANCE IC 61.1-D2.1
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
FILED benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information Mill 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.
PART 1: PROPERTY INFORNIA ION
APR 8 2011 Taxpayer Name Location Address
Williams, Timothy L
6711 S 950 E
GIBSON COUNTY AUDITOR OAKLAND CITY IN 47660
2870
Timothy L Williams ii 111111_1111 ii[III[1011_II0111011.111111111l1111hi 11 1W
6711 S 950E
OAKLAND CITY IN 47660-7730
iIIIEItliltrtin. ,ttiltllFtiEIFIIIIIEII"I1III'll1l1"ill""1II State Parcel Number Legal Description
26-20-15-200-000.322-001- /PT E NE 15-3-9.67 AC
•
5
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: TAXPAYER INFORMATION
Ov, 1 • First Middle Last
7'�o+ti L. W711, 4m5
Mailing Address(num and street,city,state,and ZIP code) . Ect‘ne as property address
Spouse ��-/ First Middle f - r Last
IKureh I
Mailing Addres.5-(N/untie-fad strei city,Tate and ZIP Code)—_ "( ame as propenyaddress - - _ _
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