HomeMy WebLinkAboutHomestead_Davis (4)�-
t, CLAIM FOR HOMESTEAD PROPERTY TAX �YEAR i STANDARD if SUPPLEMENTAL DEDUCTION FORM
Slate Form 5473 (R21 / 7-25) HC10 L)1-01
���... Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
NOTE., Telephone, Social Security, drivers license, state identification and federal identification numbers are confidential under IC 6-1.1-12-37
ffCERTIFICATION
I (We) 4r. �L l.,{ E.'' t/ j-'�Z �.._](E 1 I certify that I (we) occupied as my (our) principal place of
residence or am (are) buyj y e following ascribed real property under contract for which a Homestead Property Tax Standard Deduction is hereby claimed on the
date t ,is application Is signed, �2 — c:jP (date of signature). I (We):
❑ Own. []Am (are) buying under recorded contract.
❑ Am (are) entitled to occupy as a tenant -stockholder of a cooperative housing corporation.
❑ Have a beneficial Interest In the trust or the right to occupy the property under the terms of a
qualified personal residence trust.
❑ Am (are) the shareholder, partner, or member of the entity that owns the property.
INFORMATION
Name of Claimant (legal name)
Tele(pho]ne Number of Claimant �7
Email Address
\� 'C1L
I1� —l'Ico/
Social Security Number of I m`t aant (last five digits)
Driver's icen a I Identification I Other Number of Claimant (last five digits)
(APPllcabla only if applicant does not have a social security number)
Issuing State
Name of Clalmant's Spouse (legal name)
ic c 611
Social Security Number of Claimant's Spouse (last five digits) Driv s License Identification /Other Number Claimant's Spouse (last five digits) Issuing Slate
(Applicable only if applicant's spouse does not have a social security number)
CONTRACT•-•
If Buying on Contract, Fee Simple Owner's Name
Recorder's Office Where Contract is Recorded
PROPERTYMMM
DESCRIPTION
Record Number
Page
Coun }
T wnshiI)
Taxing District (city, town, township)
C o_ U1 3c,--16
Parcel Number
Legal Descdpbon Is
the property in question:
•. eal Property ❑ Annually Assessed Mobile Home (IC 6-1.1-7)
If any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that structure is used to produce income, describe the use and portion
of the property utilized to produce Income.
al��I a--O% -IOLA
PROPERTY
State County
Township Is Clalment Vacating a Homestead
❑ Yes 10
I hereby certify the above statements are true, correct, and complete.
Sigta Is mant
r�y�000���...���
Address of Contact (number and street, city, state, and ZIP code)
tQc Q, 2d .tee
Address of Vacated Homestead, if any (number and stre , ity, state,nd ZIP de)
"L t
,_1a,y 0
.-
Land Not Exceeding One (1) Acre Immediately
(1)
SurroundingResidential improvement
Other Land
(2)
Total Land (Line 1 plus Line 2)
(3)
Residential Improvements or
Dwelling
(4)
Annually Assessed Mobile I
Garage
(5)
rl
('
Manufactured Home
Other Improvements
(6)
Total Improvements (Line 4 through Line 6)
(7)
Total Value (Line 3 plus Line 7)
(8)
N p
I hereby certify the above is true, correct, and complete.
Signature of Assessor SQ
G\8
a Signed (date, month, year)
Verifying Action - Signature of Auditor Date Signed (date, month, year)
STANDARD DEDUCTION ALL
For assessment dates after December 31, 2024: in 2025.
20 Pay 20 $48,000; in 2026, $40,000; in 2027, $30,000; in 2028, $20,000;
In 2029, $10,000; and beginning with the 2030 assessment date
and for each assessment date thereafter, $0.
Notwithstanding any other provision, the sum of the deductions provided in IC 6-1.1-12 to a $
mobile home that is not assessed as real property or to a manufactured home that is not
assessed as real property may not exceed one-half (1/2) of the assessed value of the mobile
home or manufactured home.
Signature of Auditor
step 1--a-ate.
Date Signed (month, day, year)
U15TRIBUTION:Original— County Auditor, File -Stamped Copy — Taxpayer k1--�
Pagel 0 3
;���` `*""°- CLAIM FOR HOMESTEAD PROPERTY TAX
� CREDIT/STANDARD DEDUCTION
� Sta;e Fortn 5473 (R2 / S92)
�e
INSTRUCTIONS: See reverse side lor filing instructions.
FORM
HC70
YEAR
� i3��
' CERTIFICATION STATEMENT ° � �
�.,
�e) certify that on the 1 st day of March, 79_
I(We) occupied as our princ' al lace of residence the following described real property for which a Hm+etYead �oq�ax Credit is hereby claimed:
IVUY V
❑ �I (We) owned ❑ Are buying under conhact � � , /�
❑ Have a beneficial interest in the eniity that is liable for the property taxes on the property and that owns the propp,ly or is in under a contract.
.. �� _->- ,� .
Ni;�:
�.. �:�r�� en 170R
� CONTRACT RECORDED `�� V � � �� � � �
tl buying on contract, Fee Simple ownefs name �
RecorCers otfice where conVact is recOrtled ' Record number Page
� PROPERTY DESCRIPTION
Counry TownsNp � Tadng tlistrict (ciy, town, fownship)
P r n mber Legaldescription
�b- b sia� � c,� -a-i � ,ss 3 ��
It any portion ot the resitlential strucWre or ihe lantl not ezceeding one (7) acre that immetliatey surtounds Ihat siructure is used to produce income, descnbe Ne use antl portion of
the OropeM utilized to produce inrnme. .
PROPERTY OWNED BV CLAIMANT IN OTHER COUNTRIES
Counry Township . Counry Township
ignatu e o daimant
I hereby certify the above statemenis are true, correct and complete.
.�-a�+
�dress (number anC streel, ciry, state, ZIP code) �
ASSESSOR USE ONLY TRUE A ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not exceeding 1(one) acre immediately (� �
surrounding resideniial improvements.
Otherland (2)
Total land (line 7 plus line 2) (3)
. Dwelling (4) -
Residential improvements
Garage (5)
Other improvements (6)
Total improvements (line 4 through line 6) (7)
ToWI value (line 3plus line 7) (8)
I hereby certify ihe above is true, correct, and Signature of Assesor Da[e signed
complete.
Verifying action - Signature of Autlitor Date signetl
STANDARD DEDUCTION ALLOWANCE
19_ Pay 19 _
Lesser of 1/2 Homestead �
Valuation or S2,000
Signature of Auditor Date sgnetl
0
Gibson County Auditor
701 N. Main Stre2t
Princeton, IN 47670
FILED
DEC 11 2012
_ C.`J.n�.,"-�ry
v�
1083G�BSON COUNTY AUDITOR
.T.\11
IP:ASLRFAlOF.LISIA
I lI�A�R Il' 0.::-L-f :
InAicidua6 anJ marrKVl mupli�+ arc limited to nnc honx�tmJ .tarni:rd drJuaiun. :\> iF,c recrfp� of :hi. Jttluc�ien becomr>
morc M1cncficial. Ihcr. ix rtrom ir,crn�i�c �han crcr for hoinc>tmd (mud Hwnc�tcad fnud caums iichcr m� bilk lor alh th-rcium.
IIIiA Ii{4-1q74 rcVUir� taspa.rn utro rcc:irc :hr homr>tcad wanJarJ dniuc�ion �o ctrify �ha� Um)" arc eligiNe ro recri�r �ht
hrocfii atxl m puniJc aJdi�inul idrmifi�inp ir.fixmaii�m nc:cwn� io alkwv cuumy em'cmmcm :0 6rncr nwnnor homc� �d
filir.u. Thi> intomu�im xill be Aep crnfidartial vnd can onk be acmaitl by audwnzeJ rnunq' o0icul.. The Dapanmam of
Local Go�crrr.wm fimncc ��ill usc �his infafmation �o cr.atc irnl: ;ha1 x�ill M1clp counrv nlTcul> climinim homc>�caJ Inud.
. . . � . . � . �
TaxoaverName LocationAddress
Davis, Grady P
Grady P Davis
1760 OuterLake Rd
PrincetonlN 47670-8884
Il�ll�ll�lli���lllilli�li���i�lil��li����ii��i��i�li���l�l����l��
7760 OUTERLAKEROAD
PRINCETON IN 47670
Il�lulll��lll ullu' ullull�l I��III ulull�ll �II�II�III �II�II I�I �II�I �II�II�I�I� II II
State Parcel Number Legal Description
26-12-09-104-001.512-027 PT SE NW 9 2 70 .622 AC
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.