Homestead_EverttZA
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eE g CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
s� CREDIT /STANDARD DEDUCTION HCto
State Form 5473 (R215 -92)
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INSTRUCTIONS: See reverse side for filing instructions. 6P
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C TIFICATION STATEMENT -
• =) `� . - certify that oaf tBy,&M - 1
II We) occupied as our principal place of residence the following described real property for which a Homestead Property Tax C� I VR imed:
Ld
l(We)owned ❑ Are buying under contract
LIJ�� Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the propert y or is buying under contract.
CONTRACT RECORDED - -
It buying on contract. Fee Simple owner's name - -
Recorder's office where contract is recorded Record number Page
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
PROPERTY DESCRIPTION
County
Township
Township
p
I hereby certify the above statements are true, correct and complete.
Taxin disstNtrii�ct (city. �rb^wnn�, �toow^wnship),
I �YJ7r `C-`�
Parcel nu ber
-c�fa
Legal
lion
�Uj NJ
ao-1) 9 1�
It 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.
7 —ooS
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
r ^nty
u
--
Township
County
Township
p
I hereby certify the above statements are true, correct and complete.
Signature of claimant
Address (number and street. aty, state. ZIP code)
��
ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON - RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
S
Otherfand
(2)
Signature of Auditor
Total land (line 1 plus line 2)
(3)
ned = - -
n
Residential improvements
Dwelling
(4)
Garage
(g)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 pfis line 7)
(6)
1 hereby certify the above is true. correct, and
plete.
Signature of Assessor
Dale signed
...ying action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19_ Pay 19 "
Lesser of 112 Homestead
S
Valuation or $2.000
Signature of Auditor
j
Date si
ned = - -
n
!l...TE FORM!!M'Ali NMI TRFAS11LEA FORM 73-IA
• APPROVED BY C1.V L BOVtntN."(nil il.Ail. PRritIFIn)BY TIDE DEPART/NTOF LcsALrovaRTIMTAT MACE IV 6-I.1.L'4.I
Gibson County Auditor
1Q1 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than net for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
• �B. HEA 134-1-20119 requires additional ers who receive the homestead standard deduction to verif that they are eligible m reccne the
Yq�p....+.f✓!, t > benefit and to pnn'ide adition identifying information necessary to allow county government to better monitor homestead
i filintg.This information will he kept confdenial and can only be accessed by authonzed county officials.The Department of
7
Local Government Finance will use this information to create tools that will heap county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
APR 2 6 LUIU Taxpayer Name Property Address
Evertt, Harold
/(l 317E\fain ST
GIBSON COUNTY AUDITOR Francisco IN 47649
4576
Harold Everett
317 E Main State Parcel Number Legal Description
Francisco IN 47649-9711
I t ItRlltrtlrlltlr'rtllt ltt lulu tltRl'tl it'll IIII tIII'IIRIII IIII 26-13-20-101`-0 0000.127-005 012-00127-00 PT NW NW 20-2-9.67 AC
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
,.
/�A/2o/i� I ACC
��i �rr
41,Address(number and street.city,state,and ZIP code) - - _— - — -Same as property address - — — — — —
�3 / 7 24-a fiir1)
Spouse First Middle Last
Mailing Address(Number and street,city,state.and ZIP code) Same as propene address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
sum
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 Ie for back taxes and substantial financial penalties.
Owner 1 S. natu (...a Dale
•