Homestead_MilesCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (R6/4-03)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
FORM YEAR
HC10 F
n t
I (We) (! /
certify that on the 1st day of March, 20 I/
I (We aupied as our principal place of residence the following described real property for which a Homestead Property -Tat Credit is tiereby,c(almed:
'It(We) owned ❑ Are buying under contract �� G1BSOty
—. Have 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.
ONTRACT
v�C'RECORDEDs'7': rk„' :'•' - t Farb •.'
:s -rE.z� P�s''�`Sr''.= t"= ac.a?xt `_" •N mw
If buying on contract. Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
PROP, ERTIOESCRIPTION
County
Township
Tadng district (city, mwn, township)
Parcel number
O
Legal de ' tion M
Is the property in question:
%OF TiY
� / • / (I
I property ❑ Mobile Homo (I.C. 6-1.1 -7)
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.
- 3-/ -aoi - -mss
':<e- 'l"� - -` - s)'; PROPERTY: OWN ED -:BYCLAIMANT;IN:OTHERCOUNTIES ',-y_- Vi z � ? •'"3 ' xs'' •.
County
Tovnship
County Township
I hereby certify the above statements are true, correct and complete. Signature of cl ' ant
A.
r
�'ress (number and street, city, state, ZIP code)
VALUE.
1-� lY .iv
ASSESSORUSE ONLY -x` "z �"�^
.
r TRUE ;7X _ -
ASSESSE16,1 L E
r - �•
aaHDMESTEAD -�`
_- Ya
VALUE.
%OF TiY
VALUEt
VALUE- '.
_AT�700
Land not exceeding 1 (one) acre immediately
DhYn�-
surrounding residential improvements.
Other land
rim
2
()
,. ,
5145-
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
T+eCh Yxr �y eT �'_r
Y `+' }��'� f �' f• "if�'ijLi'+,i
Residential improvements or Annually
Assessed Mobile / Manufactured Home
Garage
(5)
K 11
Other improvements
(6)
a».
I _>:
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(6)
I hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete. -
Ve ifying action - Signature of Auditor
Date signed -
20 _ Pay 20 _
Lesser of 112 Homestead
Valuation or 535.000
Signature of Auditor Date signed
rP SIATE FORM!Mt.IRU'AM lfl%S11AfA FORN 73-IA
APPROVED BY SIStT B(VODOF nma!STS.yr+ PtrstmmnY lilt DErARinQVTOr LOCAL C.IWERVMrN'r FINANCE IC 6-1.1 C-a.1
Gibson County Auditor
10•2,N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 IndividuaLs and married couples arc 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 receuc the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.'this information will he kept confidential and can only be accessed by authorized county officials.'Ile Depanmem of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY ECFORMATION
Taxpayer Name Property Address
Miles, Lisa Etal
604 W Chestnut
Francisco IN 47649
4479
Lisa Miles
P O Box 302 State Parcel Number Lezal Description
FRANCISCO IN 47649-0302
Itlttlitrtltlltttlttlltlrtll
Hill I III....tltlttlltl 26-13-19-201-000.121-005 012-00121-00 F MC 25
X
PART 2:TAXPAYER INFORMATION
Owner I t Middle Last
i. is ice. ni?e <<e i'YI,/cs
�tg Address(number and street,city,state,and ZIP code) "1 J 0 - - Same as property address – — -- —
L0 -1 tOt CneSfns.J–St' ,. !LrangiS�v zlil y7t ti/9
Spouse /,,--- First Middle Last
;cp V l2 1 4-f/ 0 //l ( , des
Mailing Address(Number and street,city,state,and ZIP code) I Same as property address
1&,27 30a 3rttnc ca .rr tJ y7&e/9.
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
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