HomeMy WebLinkAboutHomestead_Hopkins STATE FORM 5350(P3/6-10) TRASIRFA FORM TS-IA
,• APPROVED BY STATE BOARD OF ACCOUNTS YW rRESCRIOFD BY TIIE DEPARTMENT OF LOCAL GOVERNMENT MITE IC6-11-22AI
Gibson County Auditor IMPORT ANT 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 tax bills for all;therefore,
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
benefit and i ti orm�iti additional identifying confidential itial and can necessary to allow county iz government d Lu oto fficials.ciaer monitor homestead
of
Ng filings.This information will be kept wn5dw[ial and can only be accessed by authorized 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 5 2011
— Taxpayer Name Location Address
C. . Hopkins, Dorothy
7470E SR 64
- GIBSON COUNTY AUDITOR
FRANCISCO IN 47649
285
Dorothy Hopkins 11010111_DIIIoiii DIIIDIllnootito m111:IIoii_II]IIIIIDIIIII-II_000011111111II
7470 E SR 64
FRANCISCO IN 47649
State Parcel Number Leqal Description
26-13-20-200-000.286-004/PT NE 20 2 9 2.439 AC C-1 0-7
S
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.
sv}*a U[�Y:may st to kM Dal tam RV II DTs
O. 9niz4 First W Middle /�� Last
Mailing Address(number and street,city,state,and ZIP code) ❑ Same as property address
7 9 70 E sib G y .t-a-,r. .,), i 1Y7 ! `/ 7
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) fl Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
I I I I I I I I I State
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 1 Signature Date
FORM YEAR ---
:
HC10
- -- - --------
0Z�t 'CERTIFICATION STATEMENT
or), Z. . . -
I (We) Poo, ity'M 241 st day of March, 20
I (We) oc-cupP u' P7 ipal place of residence the following des real propffy for which a HoArthd I Credit is hereby daimed:
❑ I (We), cl ❑ Are buying under contract
lave a beneficial interest in the entity that is liable for the property taxes on the property an w under a contract.
U u
jI Ty 4UOITOR
()Il -!Y AU
RECORDED
If buying on contract, Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
PROPERTY.DESCRIR-Ti N
County
Township
CLAIM FOR HOMESTEAD PROPERTY TAX
Parcel number
CREDIT/STANDARD DEDUCTION
the property in qu ton:
in
State Form 5473 (R5 / 10-01)
np� ac g -
Prescribed by the Department of Local Government Finance
FORM YEAR ---
:
HC10
- -- - --------
0Z�t 'CERTIFICATION STATEMENT
or), Z. . . -
I (We) Poo, ity'M 241 st day of March, 20
I (We) oc-cupP u' P7 ipal place of residence the following des real propffy for which a HoArthd I Credit is hereby daimed:
❑ I (We), cl ❑ Are buying under contract
lave a beneficial interest in the entity that is liable for the property taxes on the property an w under a contract.
U u
jI Ty 4UOITOR
()Il -!Y AU
RECORDED
If buying on contract, Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
PROPERTY.DESCRIR-Ti N
County
Township
Taxing district (city, town, township)
Parcel number
L g a
the property in qu ton:
in
I hereby certify the above statements are true, correct and complete.
np� ac g -
Its
property ❑ Mobile Homo (I.C. 6. r'.1 -7)
If any portion of the residential structure or the land not exceeding one (1) acre th medi . ately surrounds that structure is used to produce income, describe the use and portion
of the property utilized to produce income. q3q)q
47
K
OFfCiO.tiiTY.bWNE6BYtL'AIM—ANTIN OTHER tA ?"i
County
s.!HOMESTEAD
Township
County
Township
I hereby certify the above statements are true, correct and complete.
Sign lure claimant
t
(TmP6)2nd street,
f
tat
ty, ZIP
lle:'� %VV7 V 9
yk, .
—, —1,_ �
-�`TRLIE-.TAX_'!�-''F
'AiSESS1E_D_VALUE
'AT
s.!HOMESTEAD
NON -RESIDENTIALM"'P.
AWXTZ�WnAMMW
IJE,
00 FXTV�
?VALUE��!
Land not exceeding 1 (one) acre immediately
Signature of Auditor
w
surrounding residential improvements.
Other land
(2)
Total land (line I plus fine 2)
(3)
Dwelling
(4)
Residential improvements
Garage
(5)
Other improvements
(6)
Total improvements (fine 4 through line 6)
(7)
Trial value (line 3 plus line 7)
(8)
1 hereby certify the above is true, correct, and
signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
I
TANDARUDEDUCTION ALLOWANCE
20 _ Pay 20
Lesser of 112 Homestead
Valuation or $6.000
Signature of Auditor
w
Dale signed
114=z
E.