Homestead_Bailey (3)CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
✓ State Form 5473(R51 10-01)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
FORM
HC10
PR I Y OPERTT -- -dW 15�
DESCRIP.Ti
County
Toornship
Taxing distri ty, I to n, I hip)
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I hereby certify the above statements are true, correct and complete.
Legal description )
I IsTe' property qu
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Real property 0 Mobile Home U.C. 6-1.1-7)
If any portion of the residential structure or the Land not exceeding one (1) acre that immediately surrounds that structure is us 'o produce income, describe the use and portion
of the property utilized to produce income. �o
RIROKERTiY,61NNECIBY 3,k
County
T shin
County
I hereby certify the above statements are true, correct and complete.
sig!wr t of claj 9
A/Z
4W
+ress (number and street, city, state, ZIP code)
'16 F' A
_5 7,lleee 7 174#9
f
TANDARUDIEDUCTION'ALLOwANCE
20_Pay2O_
Lesser of 1/2 Homestead
Valuation or $6,000 TS
Signature of Auditor Date signed
TRUE
NONIESIDENTIAQ
ESUS
SOR, EONM
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Land not exceeding I (one) acre immediately
surrounding residential improvements-
Other land
(2)
— if
IWO
Total land (fine 1 plus line 2)
(3)
Dwelling
V --m---
(4)
Residential improvements
Garage
(5)
q"
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (fine 3 pits line 7)
(8)
I hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
TANDARUDIEDUCTION'ALLOwANCE
20_Pay2O_
Lesser of 1/2 Homestead
Valuation or $6,000 TS
Signature of Auditor Date signed
STATE FORM!rt. r',+rvr tRrWIIEA FORM 73-IA
AITIONED By MATE BOARD OF AM* son rtn,➢m BY Tilt DEPMneff Or LOCAL WSCRVMUTT FINASC'E K It-r4.I
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couple,are limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than ever for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
HEA 1344-2000 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to recd.,'the
benefit and to provide additional identifying information necrsslry to allow county government to better monitor homestead
filing,.this information will be kept conlideruiat and can only he arse:sed by authnri,ed county officials_The Depanntent of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Bailey, James D/Neal D
I t `gt C Po Box 53 •
r
Francisco IN 47649
4646 a. 1, ,,d,.. ��
James D Bailey 0 0
7202 E SR 64 State Parcel Number Lesal Description
Francisco IN 47649
26-13-20-202-000.260-005 012-00260-00 M 8 C ADD 8PT/17
PART 2: TAXPAYER INFORMATION
Owner I gA First Middle g Last
emg Address(number and strut,city.state,and ZIP code) — - - -- - —— U Some as property address -
P. O. Sox 2.a4 , PnapcIsto 1176111
Middle Last
Mailing Address(Number and street,city,state.and ZIP code) ❑ Same as property address
Social Security Number(last 5 digits) Drivers License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
5a
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 /�� Dare
( )
PART 4:ADDITIONAL INFORMATION