Homestead_Mays ILVt FORD'Mt*oc;FWI EnrAsltIA FORM?-IA
.AFFRIB'ED BY ST■TE KARDtW N1111 4■75.2WN FRLnaW BY 1110 DEPMt%O4T OF LOUT IXTZRYMFA'trP:ANCE M A.I-L4.1
Gibson County Auditor
101 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 ever for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
• HEA 1 344--2009 requires taxpayers who receive the homestead standard deduction to verify that they arc eligible to troche the
benefit and to pmc'ide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will be kept confidential and an only be accessed by authorized county officials.The Department of
Local Government Finance will me this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Mays, Scotty/Sherri
218 S Seminary
Princeton IN 47670
1181
Scotty/Sherri Mays
218 S Seminary State Parcel Number Legal Description
Princeton IN 47670-2120
Irl11l'111I1II11IF11'111111111113,111111111 IIIr1'1ltltll 26-12-07-401-001.464-028 019-01464-00 PT SE 7-2-10.12 AC
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PART 2:TAXPAYER INFORMATION
Owner I
First Middle Last
SCcy I (--1) H g ALA (n S
_
III
g Address(number and street,city,state.and ZIP code) - -_ -- - - — Same as property tddnse — - --' —
3 S e-m IIYI u�(t{
Spouse First Middle Last
5h-Err- 1' Lynn fill A—Li S
Mailing Address(Number and street,city,state,and ZIP code) IN Same as property address
Each undersigned certifies,under penalty of perjury,that the above and foregoing information is tale and correct and that he or she is eligible to
receive the homestead standard deduction ow 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.
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CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Form 5473 (R2 / 6s2) �
INSTRUCTIONS: See reverse side for liling instructions.
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CERTIFICATION STATEMENT
I(We) certify t on ihe 1st ay f arch,
1(VJe) occupied as our p n ipal place of residence the following describe eal property for which a Homestead P e�
❑ I(VJe) owned Are buying under coniract GIBSON COUNTY 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 contreci.
� CONTRACTRECORDED
If buying on contract, Fee Simple owners name
Recordefs ottice where contrad is recortled Recortl number Page
PROPERTY DESCRIPTION
Counry ' Township Ta�dng tlistrict (dry, town, township) �
Parcel number Legal descriptio �
4 (o � � � - —
II any poNon ot ihe residential siructure or the lantl not exceetling one (1) acre that immediately surtoun s ihat structure is used to roduce income, describe the use and portion of
the property ulilized to produce income.
PROPERTV OWNED BV CLAIMANT IN OTHER COUNTRIES
Counry Township Counry Township
Si re t c imani
ereby certi(y the above sta ments are true, cortect and complete. •
Addr (n� � arM st L ciry, s , Z1P codeJ �
ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not exceeding t(one) acre immediatety (��
surrounding residential improvements.
Oiherland (2)
Total land (line 7 plus line 2) (3)
Dwelling (a)
Residential improvements
Garage (5) -
Oiher improvements (6)
Total improvements (line 4 through line 6J . (7)
Total value (line 3 plus line 7J (8)
I hereby Certify Ne above is true, CorreCt, and. SignaWre o( Assesor Date signed I
complete.
Veritying action - SignaWre of Autliror Date signetl
STANDARD DEDUCTION ALLOWANCE
19_ Pay 19 _
Lesser o( 1/2 Homestead r�
Vatuation or 52,000
SignaNre of Autlitor Dat si netl �
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