Homestead_Hollinger STATE FORM'meant-is-en TREASURES FORM i5-IA
' ArrRIwLn BYSIAIE aOsSD rWM Ya4\TS.!vv PEfwnnEm BY THE DEPMTMER(F LOCAL GT[RW.ITT FR:AVCE M41.�12-a1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead sandanJ deduction.As the receipt of'this deduction becomes
more beneficial,there is more incentive than ester for homestead fraud homestead fraud causes higher tax bills for all:therefore.
HEA 1344-2IX9 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
filing.This information will he kepi confidential and can only be accessed by authorized county officials_The Department 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
Hollinger, Allen D/Jennifer A
912 5 Adams
Princeton IN 47670
1354
Allen D Hollinger
912 S Adams State Parcel Number Legal Description
PRINCETON IN 47670-2702
Itiullnrirlininrill IIu1IIInntltkutIInItInItII 26-12-17-101-000.756-028 019-00756-00 KUNKEL ADD 34
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.
PART 2: TAXPAYER INFORMATION
Owner I . First Middle Last
A LE&t/ Doo& t!4 S NOGLh/GL-`3Z
•ng Address(number and street.city,state,and ZIP code) 12i,Same as property address
.
Spouse First Middle Last
Tt#NiFEK AWAY v Mortfiv6e72
Mailing Address(Number and street,city,state,and ZIP cote) .!-il Same as property address
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 I Signature Date
ST�tF
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CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Form 5473 (R2 / 592) -
INSTRUCTIONS: See reverse side lor filing instructions.
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CERTIFICATION TA MENT
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I(We) `�C.. rtify that on the 1 sFday of March 19_
I(We) occupied as our principal place of r sidence the foll "ng described real property for whi a l-lome� �ad Prop ax � dit is he eby � imed:
❑ I(We) owned ❑ Are buying under contract GIBSO� COLNTY AUDITOR
❑ Have a beneficial interest in the entiry that is liable for the property taxes on the property and that owns the property or is buying under a cont2ci.
� � CONTRACTRECORDED �
If buying on contract, Fee Simple ownefs name
Recortlers offce where contract is recorded • Record number Page
PROPERTY DESCRIPTI N
n Township Taxing di � town, townShipJ
PV I 1�r O� 6 W LegaiCestri i ��
If any ponion ot the residenlial structure or ihe land not ezceeding one (7) acre ihat immediatey sunountls that sWCture is used to protluce income. tlescnhe the use antl ponion oi
the property utilized ro produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
Counry Township Counry Township
Sig ol laimani
nereby certify the above statements are true, correct and compiete. �
Address (number and sheeC ciy, state, ZIP cotle)
/c7 �. .�'2.¢_� !�1
ASSESSOR USE ONLY TRUE TAX , ASSESSED HOMESTEAD NON-RESIDENTIAL
VAIUE VALUE VALUE VALUE
Land not exceeding 1(one) acre immediately (»
surrounding residential improvementa �
Otherland (2) �
Total land (line 7 plus line 2) (3)
. Dwelling (4)
Residential improvements
Garage (5)
Other improvements (6)
Total improvemenis (line 4 through line 6) (7)
Total value (line 3 plus line 7) (8)
I hereby Certify the above is true, Covect, and Signature of Assesor Date signed
complete.
Veritying acUon - SignaNre of Autlitor Date signetl .
�l STANDARD DEDUCTION ALLOWANCE
19_ Pay 19 _
Lesser of 1/2 Homestead � �
Valu 'on or S2,000
SignaWr o uditor Date sign
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