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Homestead_Mason SLATE MIL NI WUL/•+nl TREASURER FORM 75-1A s aIMPORTANT?NOTICE TOHOMESTEADEPROPERTY OWNERS t Gibson County Auditor 101 N Main 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 eser for homestead fraud.I Iomestead fraud causes higher tax bills for all:therefore. HEA 1341-2 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to rece,e the } benefit and to o provide provide additional identifying information necessary to allow county government to better monitor homestead FILE Li filings.This information will be kept confidential and can only be accessed by authorized count officials.The Department of Local Goverment finance will use this information to create ads that will help county officials eliminate homestead fraud. PART 1: PROPERTY INFORMATION APR 1 6 2010 Taxpayer Name Prole II ��f Mason, Jeffery K/ Pamela J r" Ar 142 Box 141 01B6tON COUNTY AUDITOR Ilaubsmdt m:47639 1660 r , Jeffery K/Pamela J Mason 3645 S 450E State Parcel Number Legal Description PRINCETON IN 47670-8775 26-12-35-200-001.388-004 002-01388-00 PT E NE 35 2 10 1.01 AC ItlrrlltttltlIuIIitiIIIlIIIuIIlIlllIIluiIIIlIllIllluIlIIIIIuII D-10 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. PART 2: TAXPAYER INFORMATION Owner I First Middle Last rn ing Address(numbcf and street,city,state,and ZIP code) n Aame as property address 3(n4s S SO E Pr; iti ce-fon - 7-A) U7(a7O Spouse First Middle tan Pnmk ,7ecfn MaSOn Mailing Address(Number and street,city,state,and ZIP code) la"stene as property address 104-IS S 4--157" F Prtnce-fn,-) =/./ 87070 " 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 properly.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 CLAIM FOR HOMESTEAD PROPERTY TAX s' CREDIT /STANDARD DEDUCTION State Form 5473 (112 15-92) �a. INSTRUCTIONS: See reverse side for filing instructions. FILElm- j F RM /qYEAR �HC70 4 APR 16 1 IJ certify that on the 1st day of March, 79 occupie as ri i p ace of j9d,Wthe too i g described real pr rty for which a Homestead Property Tax Credit is hereby claimed: i (We) owned ❑ Are buying under contract _ _ - lave 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 buying on contract, Fee Simple owners name Recorder's office where contract is recorded Record number Page PROPERTY DESCRIPTION County To ip County Taxin �stric (city town, township) a-0 3H r If " Nress (number and street, dry, state, ZIP code) \ V- i ,( n Parcel number Legal description (2) Total land (line 1 plus line 2) (3) It any portion of the residential structure or the land not exceeding one (1) acrii tat immediately surrounds that structure is used to produce income, describe the use and portion of the property utilized to produce income. (4) PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES County Township County Township ®reby certify the above statements are true, correct and complete. Signature of claimant " Nress (number and street, dry, state, ZIP code) \ V- i ,( n ASSESSOR USE ONLY TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON - RESIDENTIAL VALUE Land not exceeding I (one) acre immediately surrounding residential improvements. (t) Other land (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 plis line 7) (6) 1 hereby certify the above is true, correct, and complete. Signature of Assessor Date signed ying action - Signature of Auditor Date signed 19 _Pay 19_ Lesser of 1/2 Homestead Valuation or S2,000 STANDARD DEDUCTION S Date