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Homestead_Perryd CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR a w 4 -- CREDIT /STANDARD DEDUCTION Hcfo State Form 5473 (R2/1 -90) INSTRUCTIONS: See reverse side for filing instructions. CERTIFICATION STATEMENT' 1RTT / e `J (We) U ¢ Ce.fi e K ertify that on the W10* 8f 109kh , 19 C� I (We) occupied as our principal place of residence the follo g described real property for which assHomestead Property Tax Credit is hereby claimed: (� I (We) owned (.C2Y><Rrf� der contract Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the El 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 County Township Taxing Dis ict (City, town, township) Parcel Number Lega Description 2- oaa27 -o0 r° 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. ' - 13--1 a6r0. as 7- 06.E P_ HOPtH I Y UWNtU BY ULAIMAN I IN U I t1tH Township County I hereby certify the above_ statements are true, correct and k/8,ignature number, city, state and ZIP code) �2/�-- t5 Township 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 1/2 Homestead (2) Lesser of 1/2 Homestead Lesser of 1/2 Homestead Valuation or $2,500 (3) Valuation or $1,500 Valuation or $1,500 (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 C -11 STANDARD DEDUCTION ALLOWANCE 1989 Pay 1990 1990 Pay 1991 1991 Pay 1992 19— Pay 19— Lesser of 1/2 Homestead Lesser of 1/2 Homestead Lesser of 1/2 Homestead Lesser of 1/2 Homestead Valuation or $2,500 Valuation or $2,000 Valuation or $1,500 Valuation or $1,500 Signature of Auditor Date Signed <i■lL FORM'!Mgtn,-e l WRW.WIIER FORM it-IA APPRIA'EA BTST<TF MNRD M'MTTR'ST<.snr PREANBm BY 1SL DEPARTMENT OF LOCAL ramRYMFTT FINANCE If 11.1.1-224.1 Gibsor, y Auditor Main 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 e'er for homestead fraud.homestead fraud causes higher tax bills for all:therefore. -® HEA 1344-2009 reqderes ap who receive the homestead standard deduction to verify that they arc eligible to receive the benefit nd to provide adaal identifying information necessary to allow county government to beter monitor homestead' F filings.This information will he Lept confidential and can only be accessed by authorized county officials_The Depanntent of Local Government Finance will use this infoTnution to create tools that will help county officials eliminate homestead fraud. PART 1: PROPERTY INFORMATION APR 9 LULU Taxpayer Name Property Address j Perry, Rebecca A _ °' ' 7. Po Box t?5 I I GIBSON COUNTY AUDITOR Francisco IN 47649 4488 Rebecca A Pe x 215 T" State Parcel Number Legal Description FRANCISCO IN 47649-0215 26-13-19-201-000.227-005 012-00227-00 F&MC 23/24 I rlt tllt ttltlltttltrilrim rllmrr mrltlttt llthlmt triiritittllt tl X. PART 2:TAXPAYER INFORMATION Owner I First Middle Co) Last zn t r g Address—Mamba and street,city,state,and ZIP code) -- —/ - - — - — — -❑-Same as prime fl address— 1-- -- Pa �')��X // 6;O& Ck2'S7nJi(/_r/ IRAAleISae) .1 & 76g4 Spouse First Middle Last N/A N/ A NIf) Mailing Address(Number and street,city,stale,and ZIP code) El Same as property address !v\\ if /1 Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below) 0 / 1 sm DJ/ 7T 0 / A 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 Si nature �� Date (/ ( PART 4:ADDITIONAL INFORMATION •