Homestead_SealeCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
Sure Form 5473 (R614-03)
Proscribed by the Department of Local Government Finance
INSTRUCTIONS' See reverse sidA thr fifinn intm rtinne
I (We) a2 z � Da&f'L4 certify 22tl&, e4&�W-.�fy of March, 20_
I (We) occupied as out pd cii I p ce of residence the following real property for which a HomeQRS(VroI"yjjff f%%�Hff by claimed,
r(We) owned OArebuying under contract
R 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.
It 0 NTRACM RECO
If buying on contract. Fee Simple owners name
Recorder's office where contract is recorded Record number Page
'�g g
County
To nslup
Taxing drrrhit
(9fty, to", towoship)
Parcel number
Legal description
Is the propeey in question:
zZ62 5 Q — V
=Lso 17- 2? -
>4aproperty ❑ Mobile Homo (LC. 6-1.1-7)
If any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds it —ce income, describe the use and portion
of the property utilized to produce income.
/. 0?c2s
a6-/3-17- :303-000.c2,5C)-005
PROPERTY OWhIffElY CLAIMANT
County
Toi
6V
HOMESTEADS
County Tmnship
A
I hereby certify the above statements are true, correct and complete.
S
I to of ant
`•dress (number and street. city, state, ZiPcode)
0 — /41�' 4e�
7 �
"�O' s
is L
%= 'gr -- - I
M
-
-TRUEXAX,,—,-'�'.�
-"". --i"
-'�E
AS SSEDNALUE
6V
HOMESTEADS
vaivation or $36.000
Signature of Auditor
AL
tv".W7V UE
'--.VALUE
Land not exceeding 1 (one) acre immediately
0)
surrounding residential improvements.
Otherland
(2)
"V
Total land (line I plus line 2)
(3)
'Residenfial
Dwelling
(4)
7y^iri -,
Impro vements or Annual ly
Assessed Mobile Manufactured Home
Garage
(5)
a Al
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(8)
1 hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
mAp" .5
vil L .7. Kd:e�-J li�ax' -rz-STANDARD'.DEDUCTION"ALLOWANCE
20 — Pay 20
Lesser of 112 Homestead
vaivation or $36.000
Signature of Auditor
Date signed
STATE FORM 515W(U/B-la) TREASERFR FORM T5-IA
APPPUTD BY STATE BOARD OF COUNTS,ELW PRESCRIBED DT TTO OEPAIME\I OF LOCAL GOVERNMENT FWAV(£IC 41.13T4L1
- _ Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N. Main Street Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
• Princeton, IN 47670 more beneficial,there is more incentive than ever 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 receive the
• benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will be kept confidential and can only be accessed by authorized county officials.The Department of
Local Government Finance will use this information to create tools that will help.county officials eliminate homestead fraud.
F PART I: PROPERTY INFORMATION
Taxpayer Name Location Address
MAY 4 2011 Seale,Anthony W Sr/Debra F
NC AU
310E WOOD ST
II FRANCISCO IN 47649
A6hon COUNTY AUDITOR II�I�III_DIII�III�VIII DI�III DIIIIiIIII_DII�II @fl llI1I1�11111I1II]0II�II_III I- II
•
Anthony W Seale
E Wood
FRANCISCO IN 47649
State Parcel Number Legal Description
26-13-17-303-000.250-005 ' PT SW SW 17 2 9 1.225 AC D-7
5
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.
( 1 PART 2: TAXPAYER INFORMATION
First Militlle _. — - -- -Laai — -
Mailing Address(number and street.city,state,and ZIP e) — - ❑ Same as property address
3,/C (�f/ooc� LS/ t-R if)4cisc o , r.J 76 /9
Spouse First Middle Last
.t�e��A rya_ Sege%
Mailing Address(Number and street,city,state,and P code) ❑ Same as property address
0/0 E (..00 d S /a /2cLs c 0 . --r/t) Y7 /9
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 home• -+• . dard deduction on this property. Each undersigned also understands that,by claiming additional homestead deductions
unlawfull - is- .y be iable for back taxes and substantial financial penalties.
e S 40,.. Date
PART 4: ADDITIONAL INFORMATION