Homestead_Viers STATE FORM 51569 OW&IO) 0 TFFASLAFA FOAM 15-IA
APPROVED BY STATE BOARD OF ACCOUNTS.'.O 9 IREYFInf➢fly THE UVARTNE T OF LOCAL GOStR'MANT INA'CF IC Al.13]4.I
Gibkon County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
N.Main Street Individuals and married couples are limited to one homestead standard deduction. As the receipt of this deduction becomes
Princeton,. • Princeton, IN 47670 more beneficial,there is more incentive than ever for homestead fraud.Homestead fraud causes higher tax bills for all;therefore,
`, HEA 1344-2009 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 county government to better monitor homestead
R... filings.This information will be kept confidential and can only be accessed by authorized county officials.The Department of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
IL PART 1: PROPERTY INFOR�U]TION _-
Taxpayer Name Location Address
Viers, Clyde L/Candice P -
— MAY 10 2012 450E .
C 1` FRANCISCO IN 47649 _
3500 cup
Clyde L/ IB DN yfet TY AUDITOR IIIIIIII-Bill DID/[III IIDII 0110111111 Ill 011111_11_IIIII�II011110111111111-IIIIII
12435450E
Francisco IN 47649-9014 . .
II"lll'11ll1ll'11114'I'I1"ll'IIII11'Illl'll'Il1'll'ulllllll" State Parcel Number . Legal Description
26-,9-14 400 000 406 004PT E SE 14-2-1046.90 AC C-1 D-7
id
a40_/ 2 -/y- lieu cc A , 70 a Oo-y
-91 -
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. '
—�. .e:' R INFORM. TION _�
Ov . . 1 First Middle - ' I- Last
Lee ( i erg
Mailing Address timber and street,city,state,and ZIP code)
El
.Same as property address
id) 3 s R 56DE L444/C/Sco fir) 717AV .
Spouse , 1 -
First - `Middle Last
C I \1a fee d
Mailing Address(Number and street,city.state,and ZIP code) ❑ Same as property address
Social Security Number(last 5 digits) Drivels License/State ID Number (last 5 digits) Other(please specify in Pan 4 below)
L
VSO'=- ^ J
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 1 Signature. Date
•
_ - `�RF�Rt7 YEAR
HC7UL '
AWAY 1 1995
q r
I (We) _ _ _ _ �/ _ _ certify that on the 1st day of March, 19
1 (We) occupied as our rmcipal 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 y.• -
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 buying on contract. Fee Simple owner's name -
Recorder's office where contract is recorded Record number Page
` PROPERTY DESCRIPTION
CLAIM FOR HOMESTEAD PROPERTY TAX
yr
CREDIT /STANDARD DEDUCTION ,
'
State Form 5473 (R215 -92)
the land not exceeding one (1) arse that immediately surrounds that structure is used to produce income, describe the use and portion
of the property utilized to produce income.
VALUE
VALUE
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
Township
County
Township
I hereby certify the above statements are true, correct and complete. Signature of daimant
•ass (number and street, city, state, ZIP code)
ASSESSOR USE ONLY
TRUE TAX
ASSESSED
HOMESTEAD
- NON - RESIDENTIAL
VALUE
VALUE
VALUE
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
Other land
(2)
Total land (line I plus line 2)
(3)
Dwelling
(4)
Residential improvements
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plrs line 7)
(6)
1 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
$
Valuation or $2,000
Signature of itor
DaI gne '
1 D