Homestead_McConnell (3) HATE{OK'd 5l5t IR/YNI IAFANRER FORA.73-IA
APPROVED BY MAIL!WARD OFT(COUNTS.lvn PRF9CMB1D BY 711E DEPARnnEtOF LOCAL rovnNmrnr FD:1NCE MH.1-IDLI
Gibsoti yAuditor
Man
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuah and married couples are limited to one homestead standaud deduction.As the receipt of this deduction becomes
MIP more beneficial.there is more incentive than met for homestead fraud.Homestead fraud cause higher tax bills for all:therefore.
HEA 1344--2IX9 requires taxpayers who receive the homestead standard deduction to verify that they are eligiNe to receive the
benefit and to provide additional identifying information rleces tv to allow county government to better monitor homestead
filings.this information will he kept confidential and can only be accessed by authorized county officials.The Depannrnt 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
McConnell, Sara
Rrl Box 216
Francisco IN 47649 -
4441
Sara McConnell � % h
5626 E 115 S State Parcel Number Legal Description
Francisco IN 47649-9008
1XP M CCON ELL 002-01474-00 BLDG O9 LSD GRD
lu tart ntn rtrr a nt ntnnrr r tort (1 8-2-9)002-00503
a to 3CIO C10 I .,31 -0oq
PART 2: TAXPAYER INFORMATION
Owner I First // Middle //��� Last
•
Safu ec.ft1 ri.„ (onset(nset(
mg Address(number and street.city,state,and ZIP code) i - -- — - - -®Same as property address -
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) ❑ 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)
see
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 Signature / �, Date
CLAIM FOR HOMESTEAD PROPERTY TAX FORM
a° } CREDIT /STANDARD DEDUCTION HC10
,i State Form 5473 (R2/5 -92)
INSTRUCTIONS: See reverse side for filing instructions.
�a-
_ " ^... CERTIflCATION STATEMENTS ... "_ ".. ^'.•- 6 -
YEAR
I (We) _ certify that on the 1st day of March, 19_
1 (We) occupied as our principal place of residence t e following described real property for which a Homestead D prj hereby claimed:
� V 1i 1 "( J I
I (We) owned ❑ Are buying under contract /� //jj
LI Have a beneficial interest in the entity that is liable for the or taxes on the property and that own;! Me proper!Ldis 4ing un�r a 46niract.
CONTRACT RECORDED.:..
It buying 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 description
.dress (number and street city, state, ZIP code) '
wo 2k o 1 tj -7 4 pa
VALUE -
Land not exceeding 1 (one) acre immediately
It any portion of the residential structure or the land not exceeding one (1) acre tha .m ediatey surroun s that structure is sed to produce income, describe the use and portion
of the property utilized to produce income.
-/F
O - D� - Q6
` - 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
.dress (number and street city, state, ZIP code) '
". -
TRUETAX
ASSESSED
HOMESTEAD
NON-RESIDENTIAL`,
"ASSESSOR USE ONLY - -
VALUE
VALUE
"
VALUE -
Land not exceeding 1 (one) acre immediately
--
surrounding residential improvements.
(1)
- -
Other land
(2)_p
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
-
Residential improvements
r
Garage
(5)
'
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(6)
I hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
— STANDARD DEDUCTION ALLOWANCE''
19 _Pay 19_
Lesser of 1/2 Homestead
8
Valuation or 82,000
Signature of Auditor
Date signed