Homestead_Krupicka .SIAIL FORM 535S de It'art TRUST MIN TS-IA
Aronsyn BY STAT111,11ARD nFnm L%tc9r FRISRIBm BY 1117 DEPARTMENT If LOCAL GOVE VXrtemasrric tr-I
Gibson Cdunty 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 1344-2000 requires taxpayers who receive the homestead standard deduction to verify that they arc eligible to receive the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will be kept contidential and can only be accessed by authorized county officials.lie Ilepanntent 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
_ • Krupicka, Donald E
RI Box 2 A A
Francisco IN 47649
4641
Donald E Krupicka
7146 E SR 64 State Parcel Number Legal Description _ - ___---
Francisco IN 47649 _ - ---- " -
- --- - - '-- - 26-13-20-200-001.397-004 002-01397-00 PT SW NE 20 2 9 1.135 AC
C-1D-7
X
PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
j/P/v4/ /(R v p G ICS
ag Address(number and street,city,state,runt ZIP code) -_/—/. . / _- — - - Same as property ad/dr'ess _or__ _ - ___ -
7/2 !� sIR to T f /?MJ e I 5 C 1- / IQ �-f 7 t' v I
Spouse First Middle Last
AjvAl
Mailing Address(Number and street,city,state,and ZIP code) 0 Same as property address •
Social Security Number(last 5 digits) Drivers License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
Seer
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 I attire Date
el E CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDIT /STANDARD DEDUCTION HC10
_ State Form 5473(R2/5-92)
INSTRUCTIONS: See reverse side for filing instructions.
I (We) _ (fY�,gs(.(.l _ _ _%d-LAUCArX) certifriTiat on the 1st day of March, 19
I IWe) occupied as our principal place of residence th following described real property for which a Home ad ProperV1 ax Lbedit4w5 -reby claimed:
(We) owned ❑ Are buying under contract _ _ Au11L1I 10R
LJ Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is buying under a contract.
. CONTRACT RECORDED
It trying on contract, Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
PROPERTY DESCRIPTION
County
Township
Taxing district (city, town, township)
Parcel number
Legal descri i•
�ess (number and street city. state, ZIP rode)
— —
It 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.
(2)
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
Township
County
Township
I hereby certify the above statements are true, correct and complete.
Signature of claimant
�ess (number and street city. state, ZIP rode)
ASSESSOR USE ONLY
TRUETAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON - RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Other land
(2)
Signature of Auditor
Total land (line 1 plus line 2)
(3)
ates ed ^J
Residential improvements
Dwelling
(4)
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plis line 7)
(6)
I hereby certify the above is true. correct, and
complete.
Signature of Assessor
Date signed
Verifying action - Signature of Auditor
Date signed
F I I
STANDARD DEDUCTION ALLOWANCE
19_Pay 19_
Lesser of 1/2 Homestead
$
Valuation or $2,000
Signature of Auditor
ates ed ^J