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Homestead_DunnCLAIM FOR HOMESTEAD PROPERTY TAX FORM EA 3E �Y CREDIT/STANDARD DEDUCTION �ME HCio State Form 5473(R2 /5-92) INSTRUCTIONS: See reverse side for filing instructions. NOV 16 1992 I (We) \ . — certify that on the 1st day of March, 19( I (We) occupied as our principal place residence the fdl cowing described real property for which a Homestead Property Tax Credit is hereby claimed: We) owned I] Are buying under contract �ave a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is buying under a contract. CONTRACT RECORDED - If buying on contract. Fee Simple owner's name Recorder's office where contract is recorded Record number Page " PROPERTY DESCRIPTION County Township_ Township - Taxing district (- r town, township) ; Parce number a oo egal esip ' Other land (2) ' n-2— If any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that structure is used to produce income, describe the use and portion of the property utilized to produce income. Total land (line I plus line 2) (3) PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES County Township Township_ NON- RESIDENTIAL VALUE I hereby certify the above statements are true, correct and complete. Signature of claimant WW 4e ss (number and street. city, state. 21P code) M1 ASSESSOR USE ONLY _ TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON- RESIDENTIAL VALUE Land not exceeding 1 (one) acre immediately surrounding residential improvements. (1) Valuation or $2,000 ' Other land (2) ' n-2— Total land (line I plus line 2) (3) 1 Residential improvements Dwelling (4) Garage (5) Other improvements (6) Total improvements (line 4 through line 6) (7) Total value (line 3 plus line 7) (6) 1 hereby certify the above is true, correct. and complete. Signature of Assessor Date signed Verifying action - Signature of Auditor Date signed _ STANDARD DEDUCTION ALLOWANCE ' 19 _Pay 19_ I Lesser of 1/2 Homestead $ Valuation or $2,000 Signature fA itor Date ignetl ' n-2— STATE FORM 53569(R3a-10) • TREASURER FORM TS-IA APPROVED BY STATE BOARD OF ACCOUNTS,2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6.1.1-222-Si • 0 IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS Inditiduals and married couples are limited to one homestead standard deduction. As the receipt of this ''eduction becomes more beneficial, there is more incentive than ever for homestead fraud. Homestead fraud � auses higher tax bills for all; therefore, HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the benefit and to provide additional identifying information necessary to allow county government to better monitor homestead filings. This information will be kept 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. PARTI: .PROPERTY INFORMATION - -r : Taanarer Name Properly Addres@ ( I I Pa real Number Lent Description: 309E VINE ST ( I i® Daniel.1/Cheryl A Dunn 26-13-20-101-000.184-005 PT NW NW 20-2-9 .36 AC FRANCISCO IN 47649 . SEP 7 2012 Complete and return to: C.'J.r+ N p I11I0 E�lE�EO©ElEllEIIHIIMBEI�mm®Q11 ® GIBSON COUNTY GUgDIITOR, 101 AUDITOR IN 47670 ' ` ..PART 2c TAXPAYER INFORMATION Owner 1_ _ _ .` - 11 _ ._ First i` Middle ... ` `..w , 1 ,. .. _— __ -_Last �I \ ty \ E-1..._ 3OSE2IT - V 1V Mailing Address(number and street,city,state and ZIP code) Same as property address ?O . 3� a2 FR6;NCIScco \ N y-7 695 Spouse First Middle Last C NE R\i ■ p rJ N cu rJ I..) Mailing Address(number and street,city,state and ZIP code) Same as property address ? c C3csX �-1 �2%.-.2%. • i 1,.) 4---i 6 `lei - 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 Date 9 //� PART 4: ADDITIONAL INFORMATION •