Homestead_Shoultz (2) 5151E FORM•!MaIa_/Birvt UUF SULFA PORN TS-IA
Arrrtm'FP BY MU BUVtnni ACCOUNT,, ON FVA11BFD BY 111E DEPARTMENT Of LOCAL GOVtLMMFNT FB:A'YE 6-1.1-1:4.1
Gibson County Auditor
191 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead aandanl deduction.As the receipt of this deduction becomes
- more beneficial.there is more incentive than nee 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 are eligible to receive the
benefit and to provide additional identifying information necessary to allow counts.government to better monitor homestead
tiling..This information will he kept confidential and tin only be accessed by authorized county officials.The Department of
Local Government Finance will we this information to create tools that will help county officials eliminate bewnestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Shoultz, Denise D/Tayla D
1978 S 750 E
Francisco IN 47649
1790
Denise D Shoultz
1978 S 750E State Parcel Number Legal Description
FRANCISCO IN 47649-9077
II III I III I I II I II II II I III 26-13-21-100-000.662-004 002-00662-00 PT SW NW 2129 1.1619
nu urf ru u r n rn nl nr us. of n of f AC C-1
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
en i 3h oct.Ltz
its Address(number and street city,state,and ZIP code) co Same as property address
SpwBw Dat19t w-r First Middle Last
I a 14 Let
Mailing Address(Nber and street,city,state,and ZIP code) n Same as property address
-8OZ VAIe i&n/aft'j (f . App 7Y e(ar s ?;i/ rN 41 ,29
_
PART3: ATION ' • • •
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 Signature - ' . Date
•
r
1
e) / . certify that on the 1 st day of March, 19 /
e) occupied as our principal ace of residence the fallowing described real property fcXhich a Homestead Property Tax Credit is hereby claimed:
I (We) owned ❑ Are buying under contract .
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
'
e�
CLAIM FOR HOMESTEAD PROPERTY TAX
d
CREDIT /STANDARD DEDUCTION
`
psis
State Form 5473 (112 15 92)
Legal description
,
INSTRUCTIONS: See reverse side for filing instructions.
r
1
e) / . certify that on the 1 st day of March, 19 /
e) occupied as our principal ace of residence the fallowing described real property fcXhich a Homestead Property Tax Credit is hereby claimed:
I (We) owned ❑ Are buying under contract .
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 OWNED BY CLAIMANT IN OTHER COUNTIES
'
PROPERTY DESCRIPTION
County -
Township
eby certify the above statements are true, correct and complete.
Taxing district (city, town, township)
Legal description
Signature of Auditor
�Dl aber,
- 0,- 0o
If any portion of the residential structure or the land not exceeding one (f) acre that immediately surrounds that structure is used to produce income, describe the use and portion
of the property utilized to produce income.
Total land (line 1 plus line 2)
(3)
no
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
Township
County
Township
eby certify the above statements are true, correct and complete.
Signa re o dal t
Tess (number and street. dry. state, ZIP code)
ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON-RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Valuation or 52,000
Signature of Auditor
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 plus line 7)
(8)
I hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
Eying action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE - -
19 —Pay 19_
Lesser of 1/2 Homestead
S
Valuation or 52,000
Signature of Auditor
Date signed
10
FAI