HomeMy WebLinkAboutHomestead_Cleveland SATE MAST P'MIR/t'MI UAF SL'AER FORMSIA
APPROVED B1 St 4E WARD OF ACME:T5,9.0 P[ESIUBEDDY PIE DEPARneYT OF LOCAL CATTRYMEAT r T ANCE MHL_r.'
Gibson County Auditor
11 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N
PRINCETON IN 47670 Individual and married couple.are limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than ever for homestead fraud.Homestead fraud causes higher tat bills for all:therefore.
• HEA 1341-2009 requires taxpayers who remise the homestead standard deduction to verify that they are eligible to teethe the
benefit and to provide additional identifying. information necessary to allow county government to better monitor homestead
fling:.This information will be kept confidential and can only be accessed by authorized county official.The Depanntent of
Local Government Finance will use this information to create tools that will help county official eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Cleveland, J W Trust
SR 68
EInora IN 47592
486
J W Cleveland Trust
3443 W SR 68 State Parcel Number Legal Description
Haubstadt IN 47639
26-22-09-200-000.147-024 004-00147-00 PT N NE 9 4 11/10 4 11/3 4
11 108.5610 AC D-2
X
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
c.la..ues (Li% //�a-q C' /eel e/a vcI
0 18 Address(number end nee city,state,andZl Pcode) - - .O-Same m property addles. - - - - - --- ---- - -
3443 id S RI)R Fo a s7 J7 /1/ 4.70 t'
Spouse n// Last
First Middle L
Mailing Address(Number and street,city.state,and ZIP code) Et Same as property address
Social Security Number(last 5 digits) Drive's License/State ID Number (last 5 digits) Other(please sptiify in Part 4 below)
sea
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.
net 1 Signa Date
•
a e�, CLAIM FOR HOMESTEAD PROPER '�_ FoRM YEAR
;� ; : CREDIT/STANDARD DEDUCTION . Hcio �q��
r�.`,����' State Form 5473 (R2/1-90)
'°;° WSTRUCTIONS: See �everse side for liling instructions. _
CERTIFICATION STATEMENT Dd �-�d �� 7 Od -
I(We) �l/YL�i certify that on the 1 st day of March , 19 �C�
r; We) occupi d as our principal place of residence th following described real property for which a Homestead
Property Tax Credit is hereby claimed: I(Wej owned � ❑ Are buying under contract
� Have a beneficial interest in the entity that is li ble for the property taxes on the property and that owns the
property or is buying it under a contrac
. �-�'.?-/J%.�/�-,f27-7_/�%v? �a �..s._
Counry
on coniract.
Number
- bU
where coniract is recorded
CONTRACT RECORDED
Record Nu
PROPERTY DESCRIPTION
Taxing District (City, town, township)
E q -�4--
If any portion of, tlie residential structure or the land noi exceeding one (1) acre.that immediately surrounds that struc
ture is used to produce income describe the use and portion of the property utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
ASSESSOR USE ONLY TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL
' � � - ' VALUE
Land not exceeding 1(orie) acre immediately' ' ' —
surrounding resideniial improvements (� )
Other land (2)
Total land - line (1) plus line (2) (3)
Residential improvemeMS - - Dwelling� (4) -- � - -- - - - -
Garage (5)
Other improvements (6)
Total improvemeMS - line (4) through line (6) (7)
Total value - line (3) plus line (7) (8)
I hereby certify the above is irue, Signature of Assesor Date Signed
correct: and complete
Verifying Action - Signature of Auditor Date Signed
STANDARD DEDUCTION ALLOWANCE
1989 Pay 1990 1990 Pay 1991 1991 Pay 7 992
Lesser of t/2 Homestead Lesser of 1/2 Homesiead Lesser of 7/2 Homestead
Valuation or $2,500 Valuation or $2,000 Valuation or �1,500
Signature of Auditor
19—Pay 19—
Lesser o( 1/2 Homestead
Valuation or St,500