HomeMy WebLinkAboutHomestead_MillerCLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDIT /STANDARD DEDUCTION C
Stan Form 5473 (R7 / 54M
Prescribed by the Department of Least Goverrunem Finance
INSTRUCTIONS: See reverse side for filing instructions.
I (We) certify that ono 1st day
4;lcipal place of residence the following described real property for which a Homestead Prope 9—Wf1-?isi"Feby claimed:
I (We) occupied as our ,"arch, 20_
1,21(We)owned 0 Are buying under contract GIBSON COUNTY AUDITOR
Wave 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.
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CONTRACT, RECORDEDi�,-,4Y,,Z,,t�z�,!.W�-iAtgI -*4 "-gk
It "N on contract. Fee Simple owners name
ReOwdeft oflice where xartrect is recorded Record number Page
STAN 0 ARD'D ED U C T1 0 N � AL L owAN cE kg
Caunry
County
Township
T i
bLhll-li
cly. t,:nim, fowrkdup)
9a o
Parcel number
Legal description
gA -7
a-19A( 7 nn
Is the property in question:
❑ Red property ❑ Mobil. He. (LC. 61.1 -7)
If any portion of the residential Structure or the land not exceeding one (1) acre that cnmedately surrounds dud structure is used to produce Income, desa" the use and portion
of the property utilized to produce income.
STAN 0 ARD'D ED U C T1 0 N � AL L owAN cE kg
Caunry
Township
County Township
I hereby certify the above statements are true, correct and corriplete.
d
of claimant
77�
Address(mantier and st; J, cd)y state, ZIP code)
STAN 0 ARD'D ED U C T1 0 N � AL L owAN cE kg
--, -TRUE)Wrm. i,
20 _ Pay 20_
Lasser of 12 Homestead
gp ON41ESIDENTIAIJIYT�.,M�
Signature of Auditor
Date signed
rjeff-,,.j00%OF TTV;�
Land not exceeding 1 (one) am immediately
(1)
0-1
surrounding residential improvements.
iRl
Other land
(2)
Trial land (lane I plus fro 2)
(3)
Dwelli
4)
W
06P.
P
Residential improvements or Annually
N
Garage
' 1" A
Assessed Mobile I Manufactured Home
Other improvements
(6)
ROO
Total improvements (Are 4 through fine 6)
(7)
Tbits! value (line 3 Plus fine 7)
(8)
I hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
STAN 0 ARD'D ED U C T1 0 N � AL L owAN cE kg
20 _ Pay 20_
Lasser of 12 Homestead
Valuation or 535,000 $
Signature of Auditor
Date signed
SIML r mem!!K11t: •at ttLASUrfl PORN TS-IA
ArrMNEo KY MATE b1ARDM,nvEsrs.px PRr3AIDrD BY TIL DEPARTYQYI(W LOCAL rovrtYNEAT FINANCE IC I-1.1-224.1
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 nee for homestead fraud.I lomestead 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 receae the
benefit and to provide additional identifying inPomatwn necessary to allow county government to better monitor homestead
filings.this infnrmauon will he kept confidential and can only he accessed by authorized county officials The 1lepanntent 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
Miller, Nancy
603 Chestnut
Francisco IN 47649
4512
Nancy Miller
P O Box 152 State Parcel Number Leal Description
FRANCISCO IN 47649-0152
ItItIIIluIIIIlrrtlrtlIIlulII IItIIIIIIIIItIIIIIIIuIuIIlll 26-13-19-202-000.086-005 012-00086-00 OLD PLAN 52
PART 2:TAXPAYER INFORMATION
Owner I First Last
t Middle L
A(9lif Sat /Yji�A_&Jz
"kg Address(number and street, sty,state,and ZIP code) - -- — ❑ Same as property address
O
Po . Box )55 ,FAA(?) 5/76 JY X74 c'9
Spouse First Middle Last
Mailing Address(Number and street,city.state,and ZIP code) Same as property address
Social Security Number(last 5 digits) Drivers License/State ID Number (last 5 digits) Other(please specify in Pan 4 below)
sore
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 1 Signature Date
PART 4:ADDITIONAL INFORMATION
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