Homestead_Sailer / tlirE FOR\I'!HIM=t YV+1 TRESUtn FOAM 5-IA i
/ IMPORTANT NOTICE TO HOMESTEAD rP OP TY OWNERS 1.1.1-2:-1 l
Gibson County Auditor
101 N Main
PRINCETON IN 47670 Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
:1111 more beneficial.there is more incen[ne than e'er for homestead fraud.Homestead fraud causes higher tat bills for all:therefore.
HEA 1344-2009 requires m'paiers who receive the homestead standard deduction to verify that they arc eligible to rrcene the
benefit and to provide additional identifying infom>anon necessary to allow county goemnreTI to better monitor homestead
tiling. this information will be kept confidential and can only be accessed by authnriecd county otTicials.The DepaMxnt of
V 11 ri ., local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.t—°)
.L�\Q PART 1: PROPERTY INFORMATION
PQR t Taxpayer Name Property Address
-j�''j c(�l Sailer, Beth A
N eOU °` Princeton Ohio
1563 G\BSG
Beth A Sailer
627 E Ohio State Parcel Number Legal Description
Princeton IN 47670-3029
��tl,ttrltl�trr� 26-12-18-204-003.271-028 01303271-00 SS ADD 301
Ir lrt 11rrr1r11rr1trr111 11111 rr l�r�
This form MUST be returned to County Auditor's office.
Please do NOT send this form back with your tax payment to the county treasurer. -
PART 2:TAXPAYER INFORMATION - •
Owner I First - Middle , i Last
C-11/ 4/91) Sal er
.tg Address(number and strut,city,state,and ZIP code) ' Same as property address
Spouse First Middle Last
/
Mailing Address(Number and street,city.sale,and ZIP code) C Same as property address
Social Security Number(last 5 digits) Drivers License/Stare ID Number (last 5 digits) Other(please specify in Part 4 below)
Sr
PART 3:CERTIFICATION — - -- --- - _ --- -- T
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
�� . CLAIM FOR HOMESTEAD PROPERTYTAX
' CREDIT/STANDARD DEDUCTION
`� f Sfate Form 5473 (R4 / &00)
��.
INSTRUCTIONS: See raverse side for filing insWC6ons.
FORM � Y R
r,c,o 6 3'
� � � � �
I(VJe) �� certify that on e 1st�day of A6ar , 20
I(We) occu ie s our principal piace of residence ihe foliowing described real property for which a Homes(ead�Prope Tac i i r davned:
❑ I(We) owned ❑ P,re buying under contract GIBSON CQUNTY AUDITOR
�ave a beneficial interest in the eatity that is liable tor the property taxes on the propeRy and that owns the property or is buying under a contraG.
II Ouyirrp on wnVad Fee Simple ownets name
Recordefs office where conVact is recorded • �
�3t�"=.�; � ..�:�,.,.� ,���=:�a'��"�;��.'fir���I,..-�.,t",� � PROPEF
County Township
arcel number Legal desuiption �
_ �/_ O .
It a portion ol Ne resideniial sVUCture or Ihe lantl `rot exceetling one (7) acre Na
of Ne properry utiize0 to produce income. --
Record number
Tating EicViU (ciry:
� �D' �
that struUure o used to produce'uroome, tles�
Page
ihe use and pution