Homestead_McClureCLAIM FOR HOMESTEAD PROPERTY TAX TEAR
-
. = .y ;CREDIT /STANDARD DEDUCTION FIC
State Form 5473 (R2/1 -90)
INSTRUCTIONS: See reverse side for filing instruction
C
`i c+ CERTIFICATION STATEMENT 'J_ k%_
I (We) v l.Cl/Yt�Q certify that on the 1 st day of March , 19
'(We) occupied as our principal place of residen e th following described real property for which a Homestead
Property Tax Credit is hereby claimed: I (We) owned El buying under contract
Have a beneficial interest in the entity that is I ble for the property taxes on the property and that owns the
❑ property or is buying it 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
Co u Township Taxing Dis ' t (City,-town. township)
Parcel Number Le I Descri ti� 1 a
O(2- oola5 -oo N 0 -a -9 30GC
If any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that struc-
ture is used to produce income describe the use and portion of the property utilized to produce income.
- /3 -070 - o /- 6oa. a� OQS
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County Township County Township
hereby certify the above statements are true. correct and ure
complete.
ess (Street, number. city. state and ZIP code)
O Qqq n
ASSESSOR USE ONLY TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON - RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements
Otherland
Total land - line (1) plus line (2)
Residential improvements Dwelling
Garage
Other improvements
Total improvements - line (4) through line (6)
Total value - line (3) plus line (7)
(1)
1991 Pay 1992
19— Pay 19—
Lesser of 112 Homestead
(2)
Lesser of 112 Homestead
Lesser of 112 Homestead
Valuation or $2.500
(3)
Valuation or S1.500
Valuation or 51,500
(4)
-
(5)
(6)
(7)
(8)
1 hereby certify the above is true,
correct, and complete
Signature of Assesor
Date Signed
Verifying Action - Signature of Auditor
Date Signed
STANDARD DEDUCTION ALLOWANCE
1989 Pay 1990
1990 Pay 1991
1991 Pay 1992
19— Pay 19—
Lesser of 112 Homestead
Lesser of 1/2 Homestead
Lesser of 112 Homestead
Lesser of 112 Homestead
Valuation or $2.500
Valuation or $2.000
Valuation or S1.500
Valuation or 51,500
Signature of Auditor i
Date Signed-
a SIMI FORM,37.0.I122/fell TREPSIMIL0.FORM 11A
nrrrtm'Ennl SLUE WNW OFVITR'.VSEO• IAn.RIaFDnT THE OITARn new LOCAL Gw^_RVMrNT FINANCE IC 6-1.I-t4I
Gibson County Auditor i
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 eser for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to remise the
benefit and to provide additional identifying information necessary to allow county government to letter monitor homestead
filings.This information will he Lept confidential and can only be accessed by authorized county officials.The Ikpanment of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY LNFORMATION
Taxi . . r Name Property Address
Burkhart, Marlin ucinda A
Po Box 249
*QCeLaS 11 Francisco IN 47649
4570 EYJ
Lucinda A Burkhart
P O Box 249 State Parcel Number Legal Description
FRANCISCO IN 47649-0249
26-13-20-101-000.105-005 012-00105-00 PT NW NW 20-2-9.30 AC
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PART 2: TAXPAYER INFORMATION .
Owner I First Middle /y) `r e L U R ` Last
LU c: NGS CR ,., J / I , L� �R "'Y
•ling Address(number and street.city,state,and ZIP code) . — —-- --- — - -- Same as property I'3dress" — — " " -
P c-, f,X 11 G7 met, J Aac,srr,. i+.3\-1\ey01
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) ❑ 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)
•
Sete
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 I Signature Date
)
PART 4:ADDITIONAL INFORMATION