Homestead_Rileyn, CLAIM FOR HOMESTEAD PROPERTY TAX
d�^ a
- -y ' CREDIT /STANDARD DEDUCTION
State Form 5473 (R2/1 -90)
INSTRUCTIONS: See reverse side for filing instructions.
CERTIFICATION STATEMENT
FORM YEAR
HC10 Iqq
,f (We) C t u a a SaA0 h ftfC�- certify hat on the '1§t day of March , 19 �(]
�We) occupied as our principal place of residence the following described real property for which a Homestead
Property Tax Credit is hereby claimed: 1 (We) owned ❑ Are buying under contract
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 ,it under a•contract.. I "_ Cr Eff
CONTRACT RECORDED
If buying on contract. Fee Simple Owner's Name _ J"-2 6 1990
Recorder's office where contract is recorded Record Number . Page
�
4C,0,00 4C,0,00 //�/u?^'S
AUDITU�
PROPERTY DESCRIPTION
County - Township Taxing Di s 'ct (City, t n, to nship)
Parcel Number Legal De ti n
019(_C)c � —o actej z (o
If any portion of the residential structure or the land not exceeding one (1). a re that immediately surrounds that struc-
ture is used to produce income describe the use and portion of the property utilized to produce income.
O- a3- a.�2f7 =mS
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County Township County Township__
_ hereby certify the above statements are true. correct and atur
complete.
Address (Str et, number city. tate an p ZIP code)
��O J
74 izf
'ASSESSOR USE ONLY - TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON - RESIDENTIAL
VALUE
Land hot exceeding 1 (one) acre immediately
surrounding residential improvements
Other land
' 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)
-
19 — Pay 19—
Lesser of 112 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)
Signature of Auditor
(5)
Dat Signed
(6)
(7)
(8)
I 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 112 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
Dat Signed
Lei,
SLATE FORM!TNIR'I se,' TREASURER m0.43-IA
APPRovED DVStAThRNRn or.MMlt•TS.V.„ PRUSItIFD BY Mir DEPARTMINTor L(MAL GOVERNMENTra:ASCE In-ii-E4.1
Gibson County Auditor
= 101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead aandard 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 134-120119 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will be kept conlidential and can only he accessed by authorised county officials.The Depanntent of
Local Government Finance will use this information to create 4ol3 that will help county officials eliminate homestead find.
PART 1: PROPERTY INFORMATION
— Taxpayer Name Property Address
Riley, Don Paul/Sarah Etta /0a . GU
Francisco IN 47649
4615
Don Paul/Sarah Etta Riley
102 S Watkins State Parcel Number Legal Description
Francisco IN 47649-9282
I I II III I II I I I I II I I II�� � � �,1 ,20-103-00 0.247-005 012-00247-OOCOLLINS ADD 7l6
r rr rrr r rrr tr r rr r rrrt r tt ttr r r rr �-,
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APR 1 5 ZUIU
/e _ .
PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
fi n p 4 ott L /) /z_��
mg Address(number and street,city,sate-,and ZIP code) - - - - - - __ - Q-Same as property address � - —
/ o \. !.v./Er/owe -577: F11 --71/6 is GO, //' "L' ). 7 G-- e
Spouse First Middle Last
c` /frfi H f-7-7-41 e iz �e
Mailing Address(Number and stree4 city,state,and ZIP code) El4nm as properly address
/O a _ .5; w4-e C iys s 7- F/T4-/K /s e 0, ___ -/r/ L y /=Y
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
unlawfitlly,he or she may be liable for back taxes and substantial financial penalties.
Ow Signature /� Date
PART 4:ADDITIONAL INFORMATION
•