HomeMy WebLinkAboutHomestead_Rogers STATE FORM 5350 (RI1 x410) TREASURER SJRM TSIA
APPROVED BY STATE BOARD OF ACCOUNTS,NOT PRESCRIBID BY THE OFPARTMETCF Oil/CAI.00VERNMENT FINANCE IC CI.1.222.1
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 lax bills for all;therefore,
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
T benefit and to provide additional identifying information necessary to allow county cot to better monitor homestead
1ru, filings.This information will be kept confidential and can only be accessed by authorized ized county officials.The Department of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION .
APR Z 1 2011 Taxpayer Name - Location Address
•
C Rogers, Loren UGhry) e Ni
CR 2000 S
GIBSON COUNTY AUDITOR HAUBSTADT IN 47639
2274
Loren L Rogers III Intl[hill hill moo iiljhoilhihilohililill II[I[IIOil 018110110011311111111.11 II
416 Bradley Dr •
HAUBSTADT IN 47639-8157 •
IIIIIIIIIIIIII"IIIIIIIIIItIIIII'IIII'II'I"IIIIIIIIIIIIIIIIIIIII State Parcel Number Legal Description
26-18-35-100-002.109-024/SUNSET ACRES 4
'— y
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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.
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r \ - PART 2: TAXPAYER INFORMATION '
Os. 1 First Middle - Last
Lo v , Low j�ogy I'S
Mailing Address(number and street,city,state,and ZIP code) L.Q Same as pmpeQ address
9 aar3 s� St, LA) 14 sMlf, �N ThY? .
Spouse - First 117)041' Middle `� . Last
- —
ili'1ryQ 7viv-� I C .
-- ,.raumg'rtttmesa(Numori and sneetq city:Stem;and ZIP code) ' -. _ _' . ' - �_ "'.-- '�Same as pru dfas"^_ _, "-e---'-', ---
t
9 9ai 5 J6 L1 LA/ s+a.4+'l Tr\J w7IP,�-
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.
JLA/A1 Signature - Date .
( �'�) �,�����
y�/i / ,, -
CLAIM FOR HOMESTEAD PROPERTY TAX
-� " CREDITISTANDARD DEDUCTION
t � Stata Fortn 5473 (R5 / 10-01) . � �
��� Prescribed by ihe DeparhneM of Lacal Govemment Finance
INSTRUCTIONS: See reverse side for (ling instmctions.
� � FORM�}�� � YEAR
JHC,o1V
JUL '2 5 2003
/' G!3SONC�::'.�' ,::_^:TC�i 1
I(We) R°ri�i�L�. � o��� �. certfy that on the 1sl day of March. 20_
I(We) occupied as o principal p ace ot residence e following described real �wperty for which a Homestead Property Tac Credit is hereby daimed:
�I (We) owned - - ❑ Are buying under contract ' �
■Have a benefidal interest in the entity that is liable for the property taxes on the property and that owns the property or is buying under a conVaU.
If buyNg on conirad, Fee Simple owners name
Recorders ofice where conVad is recorded
Record number � Pa9e
County TamShiP T'ng d' rict (city, tawn, fownshiP)
Parcel number L dauription �/�/� Is the property in question:
^� V.,L/.p_ �• � Droperty ❑ �deb�le Homo (I.C. & 1.7-7) .
H eny portion ot Ne residenilel strucNra w the land nd exceedinp one (1) aae that immediatey wrtounds Nat swdure is used tn produce Income, tlesaibe Ne use and portbn
ot the OroPeM util¢ed N Woduce income.
sisz�ori�
m
20_Pay20_ I
Lesser of 1f2 Homestead
Valuatlon or $6,000 $