HomeMy WebLinkAboutHomestead_Blacklock MAIL FORM.!XMI2'/■•t MAMMA FORM 75-1A
• AIPRovEn BY Min_WARD MAW/WI-5.10w PAfu1Un[DnY TIE OEPMIMEn(w LOCAL CWti9MEATFAascE le H.Ira.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 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 recehe the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.this information will he kept confidential and can only he accessed by authorized county officials.'Ow Umtnnrnt of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
_ Blacklock, James B/Amy L
3926 S 750 Ii
Francisco IN 47649
1790
James B Blacklock
7800 E St Rd 64 State Parcel Number Legal Description
Francisco IN 47649-9041
I I no III nrI III I I I nu I ' I I I I nt I I ll III 26-13-21-100-000.161-004 002-00161-00 PT NW 21 2 91.69 AC
In r u rIIru alu n n C-1
x
PART 2: TAXPAYER INFORMATION
Owner I First Middle p Last
�6ns ¶3 I'�Le.c.�l-Lo(,>r.
tg Addresf(ntiihbcr inn stayed,city,state,and`LIP c o d c j - - -- - -— Saint as property addre — -- - - ---
Ig00 E. 511 Pa (94
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) ❑Same as property address
taco E . S-L, 23 64
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 properly. 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
III
1
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDITISTANDARD DEDUCTION f fti;: E
State Form 5473 (R71 54M
Proscribed by the Departrnarvt cd Le®l Gaverramt lFinarme
INSTRUCTIONS: See reverse side for filing ins&wbDns. MAY 0 9 2008
nl=. 20
(Z) for which a Hornes==sx
pied as our pmcipal place of resi ... �ftAovdng d�!Maff)ed real for which Hcm"� cLairned:
owned PE; order as
I ) =�[] �=ArebqjM �uwnd�tat
Have a beneficial interest m the mfity that is liable for the property taxes on the property and that owns the property or is buying under a contract
ff buyvQ on mhhact Fee Sartple ownees name
Fbmxwdees attire whara, contrad m recorded Record number Page
FiRWERTY0 "EDBvxLAajtANTtN ER coumms?,,r
0'm
PitoPEwffE)EsmFv1'I0W,:
County
Carly
Toarriship
Township
Tr
Valuation or 535,000
of old
Parce'r—mmnber
7!M
a— � — q
py
s the o rl,
I 10!��
property ❑ Mobile Horne (LC. 61.1-7)
It any parUOn residential structure or the lard not exceeding one
(1) acre that ffwft t1ted s&Gcb"
m used W produce irmnhe. describe the use and patios
of the pope m produce sharer.
/
surrounding residential irnprovernents-
d6 -/3 -0? ll0 - WO. �L
FiRWERTY0 "EDBvxLAajtANTtN ER coumms?,,r
0'm
20— Pay 2O—
County
Tmnship
I ccmty
Township
I hereby certify the above stalernents are true, corned and cornpiete.
Valuation or 535,000
of old
VAr mall"
MIlltrazz, 0,urnber
or EDO E. 7777,71;,�Ci�, cn 13J. 471, 4"9
STANDAFW DEDUCTKM,ALL0WMCE:-
20— Pay 2O—
Lesser of 12 Homestead
A4,
Valuation or 535,000
VAr mall"
Date signed
Land riot exceeding I (one) sons, unrnedia"
surrounding residential irnprovernents-
Other land
(2)
Total land (Ame I pAms Ere 2)
(3)
Dweffing
(4)
Residential unprovernents or Annually
Assessed Mobile I Marrutactured Horne
Garage
(5)
Other improvements
(6)
Trial irnpruvevients (&m 4 through Ire 6).
(T)
Toted value (fine 3 phs rrm 7)
(8)
1 hereby certify Ow above is hue. cored, and
cornplete.
Signature of Assessor
Data signed
Verifying action - Sigriature cf Au&m
Date signed
STANDAFW DEDUCTKM,ALL0WMCE:-
20— Pay 2O—
Lesser of 12 Homestead
Valuation or 535,000
Squdure of AxfibDr
Date signed