Homestead_Tichenor ., ` STATE FORMT!'W IR_r YMI 'CREAMIER MN 7S-IA
.Srrdw'ED BI"SESIE MRVmOFAC(Y.ISTS.glint HFYAIBm BY nil BE?MMEVT(W wow GOVERNMENT M NCE IC 6-1.1--224I
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 e'er for homestead fraud.Homestead fraud causes higher In hills for all:therefore.
0 HEA 1344-2001;requires taxpayers who receive the homestead standard deduction to verify that they am 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 Depann,ent 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
Tichenor, Elmarie Y
1401 W VINE
PRINCETON IN 47670
426
Elmarie Y Tichenor
1401 W VINE State Parcel Number Le2a1 Description
PRINCETON IN 47670-1105
Irlrtlltttllllttlttllll Ilrtrllllttrtllllll World X26-11-12-203-002.078-028 019-02078-00 BMA 110
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.
_._ ..__ -.-° 4----'"ii;--.-a-.sF--,�3,1----"PART-:2:.-TAXPAys..R,ENFOk 1ATION�__^t. ; i_-__,-.a—„--,-,..- ----_!- '_- ---- --
Owner I First Middle --1--, Last
„ Irnarle y✓ette I ! Ghenar
ong Address(number and strut,city,state,and ZIP code) a'C'tme as property address
I `f0( Wt ✓)'rte S1-r6ef 1t )67o
•
Spouse / First Middle / Last
Mailing Address(Number and street, 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 below)
L
•
- . . ' PART 3i CERTI CA ' n T'....— mac.--- ----- :---�.,-- .— —
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 S n 7 /1e) Date y a /0'
•
R: .;} CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
� State Fwm 5473 (R6 / 4-03)
Prescribed by lhe Department ol Local Govemment Finance
WSTRUCTIONS: See reverse side lor liling insfrur,(ions.
�FORM�, YEAR
HC10
�'��,`�? �
�J
�-( i /� �
�
��e) r1 9--- "'n v ,p /,ierti(y tha`�the ��st day o�Marc.h; 20_
I(VJe) occupied as our principal place of re� ence lhe following descnbed real property for which a Hott�'restead�Propefty T��Lredit.is tiereb�y daimed:
° GIBSOIJ COU:�7 � AUQITOfi �
�I (We) owned ❑ Fve buying under contract
, Have a benefidal interest in the entity that is liable (or the properry taxes on Ihe property and that owns the property or is buying under a conVact.
If buying on coniraq, Fee Simple owners name
Recordels ofice where conVacl is recorded
County
Tamship
Parcel numher Lagal tle:
�'1��t -� n1 I
H any poAion d the residentlal sWCWre w the Wnd nm
of the properfj utif¢ed tn produce ixome.
County
Tavnship
Record numEer � Page
fown,
I� Is �he pmpe m question:
� I �leal property ❑ Mobiie Hqno (/.C. 61.7-� .
one (7) aae t�at immediatey wrrountls that sWCture is used m produce inoome, desaibe the uu antl portion
County
I hereby certify the above stafements are We, wrrect and complete. I Signature
� f�
Address (number aM street cIIy; sfate, ZlP code) _
Toxnship
� �� � �����i° �" � + ��7RUETAX����� ASSESSED VALUE-. ��HOMESTEAD '"� NONyRESfDENT�IAL �
- ., A85ESSOR�IISEONLY -'�� t .. �s,�� . � l�,.y�
s _. -. . �.�.`A��Ax. �,.�..�-'5��� �AL:UE.� ..,tt,.�` : ATa700%ry:OF�TTY� �dVALUEn.�'�S �"°3�5�„VALUE�-3.., �
Land not exceeding 1(one) aae immediatety s'+� �''"" ��.z� -z �°,cM'S,�
surtoundin residentialim rovements. ��� '��i` . ` ' " �`
9 D :a� ���4�,u'"�a..���'�-
Other land �`�``� ,q, �
i " ' 9,��, � F-
�2% ��..S��f..`'`"�sr_ y' `.�
Tdal land (line 7 plus line 2) (g) �
� .rz nF r- - s
Dwelling (q) �` .�
Residendal Improvemenb orMnuatly '���'"'.�µ .~��� ��
Pssessed Afobib I AlanufacNred Hane Garage �5� :�'y�": '�*','�'.�� ai:'.c�j�
.�5,.��...i5.
�� ' v"L �.a���
�_
Y
Otherimprovements (6) ��� �'�
a S
Tdal improvements (lina 4 through line 6) (��
Tdal value (line 3 plts line � (g�
I hereby certify �he above IS We, CorreC, and Signature otAssessor Dafe signed
complete. -
veritying adion - Sig�Nre o(luidibr Date signed
•��,�.�,-'k'��_��jp,���.��n';STANDARD:DEDUCTIONALLOWANCE,.t;�,."�.� „y��,��"�1;.R'� ."'�'�"-�"yS�s,S.��`,,,�:;.�?
20 Pay 20 _
Lesser of 1!2 Homestead �
vauauon or 535.000
5
Signature of Pudilor � Date si9netl
� �