Homestead_Holderbaugh STATE Ford!M W tie/-w l TREASULER FORM SIA
musywSO BY snit B O&RDOrMRIUSTS.211x Flax-mBED By i11L DEPARTMENT OF LOCAL r,ovrt irwT FTr:A`f.?IC6-1.14:4 I
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead standa i deduction.As the receipt of this deduction becomes
IP more beneficial.there is more incentive than ewe for homestead fraud.Homestead fraud causes higher lax bills for all:therefore.
HEA 1343-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to teethe the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
flings.This inlbrmatinn will be kept confidential and can only be accessed by authorized county officials.The Depanment of
Local Government Finance will use this information to create tools that will help county official.eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Holderbaugh, Nina J
826 S Gibson
Princeton IN 47670
1474
Nina J Holderbaugh
826 S Gibson Slate Parcel Number Leea1 Description
Princeton IN 47670-2610
IFlttlltttlellttitttlll I I III rtttllll I I Ilttlllttl 26-12-18-201-001.197-028 019-01197-00 SS ADD 106 PT/107
_ . - . _ . _ _ \ . _ _ __ - --- - _ .
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.
Spouse 0 First Middle Last
�1 Af p 0-FR Al Noi,DE2B R QL G N
Mailing Address(Number and street,city,state,and ZIP code) Q Same as property address
902 4Loary 4/&oAi SW£ET P2,Nerro, _1-T 47(p70-,2& /1
- — '
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 taxes and substantial financial penalties.
Owner �,z -- 4/ Da c
.�•n•�• CLAIM FOR HOMESTEAD PROPERTY TAX
,� a
:>'�; , ' CREDIT/STANDARD DEDUCTION
� :� State Form 5473 (R2/1-90)
�' '°�• � INSTRUCTIONS: See reverse side lor liling_instructions.
CERTIFICATION STATEMENT
�,` 1,: . :� 'L -1� �:�
�,
�
� MAY 0.3 1�� i �
�(We) �� �-°�-��/����1�a,txra_uav.n certify that on the.tst day�o'#`Fit�'���t�
i(We) occupied as our principal sidence t,�he, /following described real property for which a Homestead
Property Tax Credit is hereby claimed: . l�' I(We) owned ❑ Are buying under contract
� 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 it under a contract.
CONTRACT•RECORDED
If buying on contracL Fee Simple Owner's Name
Recorder's office where contract is recorded - Record Number Page .
• .
If any'p
ture is i
�.
�Counry
PROPERTY DESCRIPTION
Township
Legal Description
town, township)
- v v --�-� .. �u � v
i of the residential structure or the land not exceeding one O ac[e that immediately surrounds that struc-
to produce income describe the use and portion of the property utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER
Township County
� I hereby, certify ihe above,siatements aie irue, correct and
Address
state and ZIP code)
NTIES
ASSESSOR USE ONLY _ TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL
� VALUE
Land not exceeding 7(one) acre immediately
� surrounding residential improvements (�)
Other land (2)
Total land - line (1) plus line (2) (3)
ResideniiaPimprovements Dwelling� (4) - - - �
Garage (5)
Oiher improvemenis (6)
Total improvements - line (4) through line (6) (7)
Total value - line (3) plus line (7) (8)
I hereby certify the above is true, Signature of Assesor Date Signed
correct, and complete
Verifying Action - Signature of Auditor Date Signed
i
i � � STANDARD DEDUCTION ALLOWANCE
1989 Pay 7 990 1990 Pay 1991 1991 Pay 1992 7 9— Pay 19 —
I Lesser of 1/2 Homestead Lesser of 1/2 Homestead Lesser of 1/2 Homestead Lesser of 1/2 Homestead
Valuation or $2,500 Valuation or $2.000 Valuation or 51,500 Valuation or 51,500
Signature of Auditor
Date Sic
Jr- �-
�