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Homestead_Ayer•^ • CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT /STANDARD DEDUCTION State Form 5473 (R2/1 -90) INSTRUCTIONS: See reverse,side for filing instructions. I:tHIIFII;AIIUN 51AItMtNI _ FORM YEAR HC10 1 I- (We) - certify that � �oon��� the 1 Vay f rch 191 �(We) occup d as our principal place residence the following described't'dal'��jify-5i�hich a Homestead Property Tax Credit is hereby claimed: I (We) owned ❑ Are buying under contract ❑ Have a beneficial interest in the entity that is lia le for the property taxes on the property and that owns the property or is buying it under a contract:- CONTRACT RECORDED If buying on contract. Fee Simple Owner's Name Recorder's office where contract is recorded Record Number Page . IJ:L�I, �I:I�l�1�Y�laI�1L�L` Count Township Taxing Qistrict (City. town, township) Parcel Number OOQ00 L Description C� u a If any portion of the residential structure or land not exceeding one (1) acre that imme ' tely surrounds that struc- ture is used to produce income describe the use and portion of the property utilized to produce income. PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES County Township .� "— Count nship I hereby certify the above statements are true, correct and lure pefqplete. d ss (Street. number, city late and ZIP code) /U. ASSESSOR USE ONLY TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON - RESIDENTIAL VALUE Land not exceeding 1 (one) acre immediately surrounding residential improvements Other land Total land - line (1) plus line (2) -- Residential improvements Dwelling Garage Other improvements Total improvements - line (4) through line (6) Total value - line (3) plus line (7) (1) 1991 Pay 1992 19 —Pay 19— Lesser of 1/2 Homestead (2) Lesser of 112 Homestead Lesser of 112 Homestead Valuation or $2,500 (3) Valuation or $1,500 Valuation or S1,500 (4) - - - - - (5) (6) (7) (8) 1 hereby certify the above is true, correct, and complete Signature of Assesor Date Signed Verifying Action - Signature of Auditor Date Signed STANDARD DEDUCTION ALLOWANCE 1989 Pay 1990 1990 Pay 1991 1991 Pay 1992 19 —Pay 19— Lesser of 1/2 Homestead Lesser of 112 Homestead Lesser of 112 Homestead Lesser of 112 Homestead Valuation or $2,500 Valuation or $2,000 Valuation or $1,500 Valuation or S1,500 Signature of Auditor I Date Signed -a1 -9 U • • SIAM FORM ata•IR't 54/B 1AFAN101 RAW:3-IA • APPICIWE0 OPERTY�OWNERS 411-2:4 Gibson County Auditor 101 N Main PRINCETON IN 47670 Individuals and married couples arc limited to one homestead standard deduction.As the receipt of this deduction becomes more beneficial.there is more incentive than flee for homestead fraud.Iomestead fraud causes higher tat bills for all:therefore. _ HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to rotas/the benefit and to provide additional identifying. information necessary to allow county government to better monitor homestead filing`.This information will be Lep.confidential and can only be accessed by authorized county officials.The Department of Local Government Finance will use this information to create tcds that will help county officials eliminate homestead fraud. PART 1: PROPERTY INFORMATION Taxpayer Name Property Address Ayer, Janet 205 N Center Francisco IN 47649 4589 Janet Ayer P 0 Box 258 State Parcel Number Legal Description FRANCISCO IN 47649-0258 Irirrllu tltllu tlIIlltlIIlluntItltltltlII iu ititlIIintitll 26-13-20-101-000.200-005 012-00200-00 SHOP ADD 27 PT X PART 2:TAXPAYER INFORMATION Owner I First Middle Last 1/4.21 - C et t L /I-`Kr •ling Address(number and strect,city,state,and ZIP code) 0-Same ns property oddr¢; —— — --. . -- `—-. Po Bob .759 ret.yMUS&o i 7`&, y-/ 7L2yq Social Security Number(last 5 digits) Drivels License/State ID Number (last 5 digits) Other(please specify in Part 4 below) n- 37O tc4,6,33 sry Spouse � First Middle Last -«y0 N ev Mailing Address(Number and street,city,state,and ZIP code) 0 Same as property address Social Security Number(last 5 digits) Drivels License/State ID Number (last 5 digits) Other(please specify in Part 4 below) Sue 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 eliuible 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 Signature Date Telephone 91 C (,/'pJls2 5-(o ib ( a )2_) 782 - 33g0 Spouse Signatulf Date Telephone ( )l PART 4: ADDITIONAL INFORMATION •