HomeMy WebLinkAboutHomestead_Willis (3)CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
�> State Form 5773 (8215-92)
INSTRUCTIONS. See reverse side for filing instructions.
FORM YEAR
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CERTIFICATION STATEMENT
I(We) c tythat h 1st o�fp�M 1
I (We) oc u ed r princip late of residence the following described real property for which a Homest 4 AUU ed:
❑ I (We) wne ❑ 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
It buying on contract, Fee Simple owners name
Recorders office where contract is recorded
Record number
Page
PROPERTY DESCRIPTION
County
Township
Taxing district (dry, town, township)
Parcel number a-00
l d itl Legaescrpon
It any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that structure is used to produce income, describe the use and portion of
the property utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
County
Township
County
Township
ereby certify the above statements are true, correct and complete.
Si reo nt
d ss (number and street, dry, state, ZIP code)
/
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 1 plus line 2)
(3)
Residential improvements
Dwelling
(4)
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(8)
1 hereby certify the above is true, correct, and
complete.
Signature of Assesor
Date signed
Verifying action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19_ Pay 19
Lesser of 1/2 Homestead
Valuation or S2,000
$
Signature of Auditor
Date ' ned
O
515Th EOMI!)•sill w&5 TRTASU.DA r00.V 13-IA
APPROVED BY AUh IMMO OKV'KVPTt V../ tRF3111DmBY PIE DAARTVEVI CC QUErN'2RMIEM MANCE M HM:4.1
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 e'er for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
• HEA 1344-2009 requires taspasers who receive the homestead standard deduction to verify that they are eligible to reeehe the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filing:.'This information will he kept confidential and can only be accessed by authorized county officials.the Depanment of
Local Government Finance will use this information to create:mats that will help county officials eliminate homestead Baud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Willis, Jeffrey A/Susan N
none
3285 FILED 5
Jeffrey A/Susan N Willis
8469 E SR 168 APR 19 2011 State Parcel Number Leaal Description
Oakland City IN 47660 \\ r\
— _ C M— 26-20-16-200-001.812-001 001-01812-00 PT SE NE 16 3 9.809 AC
GIBSON COUNTY AUDITOR
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.
I PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
w Address(number and AMC..city,s ,and ZIP code) lyq'Same as property address.
Spouse First - Middle Last
� si91I t.2 co/ee 1 .6,; 7//r 7
Mailing Address(Number and street,city,state,and ZIP code) Same as property address
-- -- - -__. - -- -
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 'rnature , Date
-