HomeMy WebLinkAboutHomestead_Clark (3) SLATE FORM ill-/4•1 TRFANLL1t FORM.79-14
APFPWED BY SLUE WARD OF AM*NTS ns PLEYIUBED BY 111E DrrARTHETOFuEAL CASrtNMflti ftAA\'CE a'FI.1-L'J.I
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 1344-2000 requires raapapers who receive the homestead standard deduction to verify that they are eligible to recebe the
benefit and to provide additional idenurcme information necessary to allow county government to better monitor homestead
filings.this information will be kept confidential and can only he accessed by authorized county officials.The Department of
Local Government Finance will use this information to create u.ols that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Clark. Michael UJana L
Rr2 Box 92
llaubstadt IN 47639
10938
Michael L Clark
4501E 1150 S State Parcel Number Legal Description
HAUBSTADT IN 47639-7921
lrin tut um II IIIn1r u11r1nu111ut1111 11111111._ -26-23-12-300-000.315-024 004-00315-00 PT SW 12410 5.78 AC
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
M Ichatt L. C a_r 1L
_. tg Address(number and street.city.suite,and ZIP code) _ - - El Same as pioperty address_ _ ____ __ _ _ _- _
1-15e , E. i 15 S. F4-oa ,6A+ t4 t.4-7L,3
Spouse First Middle Last
1al�c�
L. C
Mailing Address(Number and street.city,state,and ZIP code) 2 Same as property address
95o i L. 115D S. 1-1-ruab51-ud+
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
•
CLAIM FOR HOMESTEAD PROPERTY TAX
- ' CREDIT/STANDARD DEDUCTION
t J StaU Form 5473 (RS / 70-01)
�� P�ascribed by ihe Depar6nent d Local Govemment F"uiance
INSTRUCTIONS: See reverse side for (ling instructions.
I (We) / / , .I:Ci/LLC.IL-( �
I(We) occupied as our principal place of residence th
� I(We) owned ❑ Are buying under conlract
desaibed real property for which a
FORM
� �N �
YEAR
a benefidal interest in the entity that is liable for the property taxes on the property and that owns the property w is buying under a contract.
If buy'u�g m conVaq, Fee Simple ownefs name
Rewrders olfice whera contraU is recorded
County
Twmsldp
N any portion W fhe rasiAantlel strucWre w tt�e land nW
ot Me property uhl¢ed tn Woduce irrcome.
Taing dje(ricl (ci4; fown,
Uie
Record number � Pa9e
Real propery LI MoD�e Hwno (I.C. b1.1-� -
one (1) �et� � y wrrounds that sW Gure is used W protluce 7ncwne. Oesuiba Me use an0 pwtbn
<3•7$�. _
I ca�lo �?_3 -�a -a 3ca�� - 06�). e i/� - C�? �`- I
" ����._�,.-��-"�?'��..��`-�sTnrinna�;oeoucnoN�nuown►ice �`�"=�"'�� .���x,.'�"•-a`.�,����'��`;��
20 _ Pay 20 _
Lesser of 7/2 Homestead
Valuation or 56,000 $
Sig�re of PLd'AV ' Date signad