Homestead_Krieg 510E FORM I)'.p.tor, TIWASUILEA r0AM 11A
.APPROcED BY STATE BMA 0 OMTIC-NI(!YN Mr3ATWBY i11L DEPAAT@Y1 OF LOU&GOVERNMENT MANCE IC 6-I.t-24.1
Gibson County Auditor
N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
?8}�
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 mgr 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 to provide additional identifying information necessary to allow county government to better monitor homestead
nlinfz,lids information will be kept confidential and can only be accessed by authorized county officials.The I)epanment of
Local Government Finance will me this information to create tsins that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Collins, Lorrie
RI I3ox 247
Francisco IN 47639
4654
Lorne Collins
C/O Jerry Krieg
7535E 150 S State Parcel Number Legal Description
Francisco IN 47649-9037
�F�tt��ttt�t��ttt�tt��t�tt�t�tt�� ��r�r rr�rr��rt�t�IFt��t� 26-13-21-100-000.151-004 002-00151-00 PT NW 21-2-940 AC
D-7-C-1
•
PART 2:TAXPAYER INFORMATION
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) (Scene as pmperty address
s
7,3 r r ICo 5 £yA"✓c i S c O // X/1/29 /7/
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 Si a Date
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (R2 / 5 -92)
INSTRUCPbN,
FORM YEAR
HC70
I - c.cm rrwHnvn arHrcmcrvi _ - ..
hI (We) certify.that on the 1st day of March, 19
) occup d as our „ncipal place of resid nce th 71ne described real property for which a Homest Ta I eby claimed:
W. ) y TT l
Lj I (We owned ❑ Are bu in ct
❑ Have a beneficial interest in the en at is liable fooper ty taxes on the property and that owns the property or is bu in under a contract.
,CONTRACT RECORDED _
If buying on contract, Fee Simple owner's name ,
Coup, " &.r inITOR
Recorder's office where contract is recorded Record number Page.
` PROPERTY DESCRIPTIO -
County - -
Township
Taxing distr t (city. town, t_
.._.,ip)
,
0 P e' ur' r
Legal description
Date signed
Otherland
(2)
If any por ion 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.
1 - -
(3)
- PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County Townshio
u y owns ip
eby certify the above statements are true, correct and complete.
Signature of c aimant ,
Address (number and street, city, state, ZIP code)
ni. MAd r'sn Aj �c, Q.a -ho( 44 twa . 5!74 G_
- ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE-
HOMESTEAD
VALUE
NON - RESIDENTIAL
-VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Signature of Auditor
Date signed
Otherland
(2)
Total land (line 1 plus line 2)
(3)
Residential improvements
Dwelling
(4)
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 pits line 7)
(g)
1 hereby certify the above is true. correct, and
complete.
Signature of Assessor
Date signed
Verifying action - Signature of Auditor
I Date signed
STANDARD DEDUCTION ALLOWANCE
19 Pay 19
Lesser of 1/2 Homestead
Valuation or S2,000
S
Signature of Auditor
Date signed