Homestead_Thomas MATE FORM!Mx.iR. MEASLIER'On.M 75tA
AIFRT'ED BY AAATE.MIAMI OFMYC[Re\Tx.2os PREy[111BFD BY THE DEPARMLYr(FL(%AL now turner FINANCE IC 11-1.1 1:4.1
0 County Auditor
11.N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
OL•N
PRINCETON IN 47670 Individual and married couples are limited to one homestead standanl deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than user for homestead fraud.Homestead fraud causes higher tax bills for ail:therefore.
• HEA 1344-2109 requires taxpayers who receive the homestead standard deduction to verify that they arc eligible to receve the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This infmmatinn will be kept confidential and can only be accessed by authorized county officials.The Depannlent of
Local Goverment Finance will use this information to create [ttds that will help county officials eliminate homestead (laud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Thomas, Laura
k i
-^_ Box 264
_ - - - - ._ -.__._._`.. — .FranciscolN 47649
4658
Laura Thomas
1936 Lakewood Circle State Parcel Number Legal Description
Francisco IN 47649-9045
II III I III I I II I III II II III 26-13-21-100-000.684-004 002-00684-00 PT SW NW 21 29 6.8381
t o nt t nt u L u t n nn a l t tat n nu r AC C-1 D-7
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
l Au SEA A) l II els
- - •tg Address(number and street,city,state,and ZIP code) - — , - - - Ni' Same as property address - - - --_
�
193 (0 .CAKew000 Cry' / FRANc;sco, I*A) Li 7byct
Spouse First Middle Last
00R.C
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 spesif-v in Part 4 below)
sox
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 Signa Date
a� g CLAIM FOR HOMESTEAD PROPERTY -TAX FORM YEAR
~ CREDIT /STANDARD DEDUCTION HCtO
State Form 5473 (R215 -92)
ieu
INSTRUCTIONS: See reverse side for filing instructions. T�
certify that on itfiltl�bf MgfiAi; 19
t We) occupied as our principal place of residence the following described real property for which a Homestead Property Tax Credit is hereby claimed:
l(We)owned ❑ Are buying under contract �yVr —e.// '61'. fur '5
Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is �ihiJlnder a contract.
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 ,
Town
i
Taxing ict (ci , town, to ship)
Parcel number
Qoa-
Lega
ri
.�-Sw
lion
nj U) Q l -a- C—.
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.
j_ /
IaQ _ CCO, -00171
- PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES '
County
Township
County
Township
_reby certify the above statements are true, corredand complete.
nature clai nt
Address (number and Vreet, city, state. /rZIP code)
i l0
.- .L.� -r }r 7
ASSESSOR USE ONLY
" TRUE TAX
VALUE
.ASSESSED.
VALUE
HOMESTEAD
VALUE
NON-RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
Otherland
(2)
Total land (line I 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 pUs line 7)
(6)
1 hereby certify the above is true, correct, and
mplete.
Signature of Assessor
Date signed
Wing action - Signature of Auditor
Date signed
Signature of
19 _Pay 19_
Lesser of 112 Homestead
Valuation or $2,000
S
ALLOWANCE
Date signedr