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CLAIM FOR HOMESTEAD PROPERTY TAX
xa CREDIT /STANDARD DEDUCTION
State Form 5473(R2 /5-92)
INSTRUCTIONS: See reverse side for riling instructions.
FORM -YEAR
HC10
I (We) - - � . . certify that on the 1st day of March, 19
1 (We) occupied as our principal place of residence t e following cribed real. property for which a Homestead Property Tax Credit is hereby claimed:
n
rH,,, ) owned ❑ Are buying under contract 77��
a b eneficial interest in the entity that is liable for the property taxes on the property and that owns the propForib in LET) - el - • • - - - JJJLLLLLL 111�� )I '
CONTRACT RECORDED - -
It buying on contract, Fee Simple owners name .. r Apsg
Recorder's office where contract is recorded Record 6ughanjT0R age
' PROPERTY DESCRIPTIO
County-
Township
Taxing distri city, own, township) -�
P el er
Legaldescnpti n
^
O
,00
J /
If any portion of the residential structure or the land not exceeding one (1) acre that immediately surrou ds that structure is used to produce income, describe the use and portion
of the property utilized to produce income.
S SS
- PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
ASSESSED
VALUE.
County
Township
I hereby certify tfie above statements are true, correct and complete.
hat a of cl man
cress (number and street, city state, ZIP code)
3a I Fl&n� H b
ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE.
HOMESTEAD
VALUE
NON - RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Other land
(2)
Total land (line I plus line 2)
(3)
Residential improvements
Dwelling
(4)
Garage
(5)
-
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 pbs line 7)
(g)
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_
Lesser of 1/2 Homestead
Valuation or $2,000
S
_a
f
at\h FOAM!!cash I'Am tPGNl',FORM 71-IA
.ANTSW'ED BY Cr wE Daum*AM A-N1(bw PAfAWprD BY nn DEPARTME`COF LOCAL OOVERSIMT FINANCE Ie�l.l_'-L.1
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS -
�01 N Main .
PRINCETON IN 47670 Individual and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial.there is more incenthr than ner for homestead fraud.Homestead fraud cause-higher tax bills for all:therefore.
0. HEA 13442009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receve the
benefit and to provide additional identifying information necessary to allow county gocemment to better monitor homesle:xl
filings.This information will he kept conlidential and can Only be acre:sed 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
Hill, William E/Nella J
PO Box 321
Francisco IN 47649
4575
William E/Nella J Hill
P O Box 321 State Parcel Number Legal Description
Francisco IN 47649-0321
1r1r t11r ttlrllrFrlt tlltlt lllIrFtrlit tdriIrtlirFltltttlittt111 26-13-20-101-000.120-005 012-00120-00 PT NW NW 20-2-9.30 AC
X
PART 2:TAXPAYER INFORMATION
Owner I /( / /r First Middle r tag
IIVd/v// (/l i e4 y / k
-
•ng Address(number and street,city,state,and ZIP code) - — - .Jp -Same as property address - — —
.
Spouse /3 First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) 0 Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Pan 4 below)
sere
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 KOWesteaddeductions - - -
unlawfully,he or she may be liable for back taxes and substantial financial penalties.
Ow r I. Date
)
PART 4:ADDITIONAL INFORMATION
7 ( c/f7.rA /7-211_a 4-'12.•./-7