Homestead_Williams (2) a
S WF.FORM 5.ISS -r"Ml tar sutra FORM.7S-IA
APnmeto By wilt BOARD.%sms—t'.am PRfz,mm BY THE DEPAar✓E`rr OF Lt CAL to'NRII FINANCE r i.I-_11
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
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 ner for homestead fraud.Ilomesteal fraud causes higher tax bills for all:therefore.
• HEA 1313-2009 requires taspasers who receive the homestead standard deduction to verify that they arc eligible to receive the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filing.This information will be kept confidential and can only be accessed by authorized county officials.The Dqurtntent of
Local Government Finance will use this information to create fulls that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Williams, Rick L
PO Box 259
Francisco IN 47649
4824
Rick L Williams
P O Box 259 State Parcel Number Legal Description
Francisco IN 47649-0259
I I III I III I I I I I I I I I I I I I I I 26-13-30-200-001.339-004 002-01339-00 PT ENE NE 30 2 9.863 AC
to nt t nt n to nor err rt art rt n nl / 0-10
PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
eky • � i� Lail//itm_s
e Address(numbs and street,city,state,and ZIP code) - - --- - Same as property dmss - _ - - _ —' - --
/?0 n F ox zfl Fie 4-n. ca //up L7&-V-9'
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) Same as property address
Social Security Number(last 5 digits) Dt Net's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
sow
PART 3:CERTIFICATION
— Each-undersigned-certifies,-under penalty-of petjury,.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 additiobalhomeste`ad-deductibns —
unlawfully,he or she may be liable for back taxes and substantial financial penalties.
Owner I Signature Date -
•
CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDIT /STANDARD DEDUCTION HC10
State Form 5473 (R614-03)
presented by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing insevc.tions,
�H
I(We) IILEJC (&ZLZ-1V9Z&Q2tg2t/ certify that on the 1st day of March. 20
I (We occupied as our principal place of residence the following described real property for which a Homestead'Property Tax Credivis hereby -7
J'�� claimed:
(We
owned ❑ Are buying under contract
NvDiTOH I
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;' ',--*-'�.�tPt-'I
If buying on contract. Fee Simple owners name
Recorder's office where contract is recorded Record number Page
Vv' t—
County
Township
County —1Township
Taxing district, tolvrl township)
Parcel number
eo c? - 3
Legal description
WE 0-,2-
"A-5-601
Is the property in question;
I property El Mobile Home (I.C. 6- 1. 1-7)
H any portion of the residential structure or the Land not exceeding one (i) acre that immediately surrounds Mat structure is used to produce income, describe the use and portion
of the property utilized to produce income.
surrounding residential improvements.
ii�� M 'ST T;ti-,'��Li4kCSTANDARD:DEDUCTION'AL--LOWANCE
County
Township
County —1Township
I hereby certify the above statements are true, correct and complete.
Signature of claimant %
Address (number and street, city state, ZIP code)
a
valuation or 535.000
ii�� M 'ST T;ti-,'��Li4kCSTANDARD:DEDUCTION'AL--LOWANCE
'TRUEiTAX�� -i:
VALUE
AS�125 E D".'VALUE
]-'Ajj90aA70FTW�
V-,HOMESTEAWA
f VALUE
OQU NkNalgESIDE Q
Land not exceeding I (one) acre immediately
$
valuation or 535.000
re of Audit
surrounding residential improvements.
Other land
(2)
nl
,
A-Iow
Total land (fine I plus fine 2)
(3)
Dwelling
(4)
r - ,
A d.,
R.
Residential improvements or Annually
Assessed Mobile I Manufactured Home
Gara ge
( 5)
L
90,
S
Other improvements
(6)
Total improvements (fine 4 through line 6)
(7)
Total value (fine 3 plus line 7)
(8)
1 hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
ii�� M 'ST T;ti-,'��Li4kCSTANDARD:DEDUCTION'AL--LOWANCE
20 Pay 20_
Lesser of 112 Homestead
$
valuation or 535.000
re of Audit
Date signed