Homestead_Eckert`'���'` -, CLAIM FOR HOMESTEAD PROPERTY TAX
� CREDIT/STANDARD DEDUCTION
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State Fortn 5473 (R2 / 592)
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, INSTRUCTIONS: See reverse side for filing instructions.
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OCT 12 1999
CERTIFICATIONSTATEMENT .J/ J
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I(We) S `�` certify tha onY' �96t!day�of March;,79�LR
\I/(W�e) occupied as our principai p a of residence the following described real property for which a Homestead Property Tax Credii is hereby claimed:
�I (We) owned ❑ Are buying under wntract
Have a beneficial interest in the entity that is liable for the property taxes on ihe property and that owns the property or is buying under a contract.
- CONTRACT RECORDED -
It buyiig on contraIX, Fee Simple owners name
Recorders office where conVact is recorded � Record number Page
PROPERTY DESCRIPTION �
Counry Township T' disirict (dry, town, tawnshrp)
Parcel number Legal descrip6on
p (q - � l (oco8--Oc7
If any portion of ihe residentiai structure or ihe land not exceetlirg one (1) acre that immediatey sunounds thai sWCWre is usetl to protluce income, tlescribe ihe use and ponion oi
the property utilizetl to protluce incame.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
County Township Counry Townsttip
Signat f claimant �
�ereby certify the above statements are true, correct and complete. •
Address (number antl s(reel, ciry, sfate, ZIP catle)
03 . C-�or.9 T ,l,C � ��J iLP7�
ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not exceeding 7(one) acre immediately (�)
surrounding residential improvements.
Oiherland (2)
Total land (line 7 plus line 2) (3)
Dwelling (4)
Residential improvemeNS - ,
Garage (5) �
Other improvements (6)
Total improvemenis (line 4 through line 6) (7) _
Total value Qine 3 plus line 7) (8) .
I hereby certify Ihe above is true, correct, and Signawre a Assemr Date signed�
complete.
Verifying acGon - Signature of Autliror Date siqnetl
STANDARD DEDUCTION ALLOWANCE
19_ Pay 19 _
Lesser of 1/2 Homestead 5
Valuation or 52.000
Signawre of Auditor Date signed
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STATE FOR�f S1569 (Rll&10) TAEASURER FOR\1 TS-IA
APPROt'ED BY S7ATE BOARD OF ACCOII�TS.'_009 PRESCRIBFD BY THE DEPNtT\1E\T OF IACAL GO\'E0..\'�¢\T FTA\CE IC0.1.i-_'?-8.1
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Individuals and married couples are limited to one homestead standard deduction. As the receipt of this
•'^duction becomes more beneficial, there is more iucentive than ever for 6omestead fraud. Homestead fraud
causes higher tax bills for all; therefore, HEA 1344-2009 requires talcpayers �r•ho receive the homestead
standard deduction to verify that they are eligible to receive the benefit and to pro��ide additional identifi�ing
information necessary to allow county go��ernment to better monitor homestead flings. This information
will be kept confidential and can only be accessed by authorized county ofticials. The Department of Local
Government Finance will use this information to create tools that will help counh� officials eliminat�
homestead fraud.
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Tatnaver \ame
lason S/ Candi L Eckert
Cm�i� /ere ar,d •el�trn to:
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Pmoeriv.�ddrecs
903 S GIBSON
PRWCETON IN 47670
Stam Parcel �vmber
26-12-18-201-001.668-028
GIBSON COUNTY AUDITOR, ]Ol N MAIN PRINCETON IN J7670
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Spousa First
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Maiivip ACtlrass (nianDer arq sireet, tiry, nate anC ZIP wEe)
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Sodal
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Leaal Drsmntian:
SS ADD 101
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Same as prvperty aEaeu 1
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Deivers Lieanse/SWte ID NuMar Qaat 5 Elpib) �v pth¢r (plaasa speafy in Part < below�
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tacn untlersignea certrties, unaer penalty ot perjury, that the above and foregofng fnformatfon is We and CorreU antl that he or she is eligible to reterve t
homestead standard deduction on this property. Each undersigned also understands that, by claiming additional homestead deductions unlawfully, he or
she may be liable (or back taxes and substantial financial penalties.
Ovrt�ar t Sipnatwa Date Teleptan .
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