Homestead_Bota • 'LATE FORM!!re IIC/ INASUrta LOAM SIA
ArPRtw'En BY ST ATE WARD OF.scro smisi 2O PRIIAIBFD BY mm DEPARTMENT IF LOCAL Cssvttsnrnl FINANCE e4-1.I-r4.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and flurried couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
r; more beneficial.there is more incentive than eser for homestead fraud.Homestead fraud causes higher tat bills for all:therefore.
® HEA 1344-200 requires laspavers who receive the homestead standard deduction to verity that they are eligible to receive the
benefit ant 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 Depannrcnt of
Local Government Finance mill use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Bota, Ronald L
RI Box 236A d
Oakland City IN 47660
4699
Ronald L Bota
R1 Box 236 A State Parcel Number Legal Description
Oakland City IN 47660-8434
26-13-23-300-001.194-006 0013-01194-00 PT SW SW 23291.45 AC
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
a,✓glQ C6'e o14
g Address(number and street,city,start,and ZIP'code) _ Snmc as rropcny ad - —- --
.2 yo ( S 9f'o 6 ovIA- 4cde Z.✓ '/7/C'O
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please spteify in Pan 4 below)
sox
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 I Signature Date
•
•
kk
c� °s CLAIM FOR HOMESTEAD PROPERTY TAX
3� CREDIT /STANDARD DEDUCTION
..;' State Form 5473 (132 / 5 -92)
rain
INSTRUCTIONS: See reverse side for filing instructions.
FORM YEAR
HC10
I (We) T (1 ) J—� Qk l L A `C7N C..IJ certify that on the 1st day of March, 19
1 occupied as our principal place of resident; the following described real property for which a Homest Property T x dais h by imed:
a
(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 ow hV*h5iI'erty- drlis�buying under a contract.
CONTRACT RECORDED -
It buying on contract, Fee Simple owner's name -
Recorder's office where contract is recorded Record number Page
PROPERTY DESCRIPTION
County
Township
Taxi dis 'ct (a , own, towns
ip)
Parcel number
—
Legal
rAddress (number and street, city, state. ZIP code)
AA v x s ti a �dn,)g,
It any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that structure is used to produce income, describe the use and portion
of the property utilized to produce income. -
(2)
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
Township
County
Township
�eby certify the above statements are true, correct and complete.
Signature of claimant �
rAddress (number and street, city, state. ZIP code)
AA v x s ti a �dn,)g,
ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE.
HOMESTEAD
VALUE
NON - RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Valuation or $2,000
Signature of Auditor Date signed
Other land
(2)
Total land (line I plus line 2)
(3)
Residential improvements
Dwelling
(4)
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plzs line 7)
(g)
1 hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
Verifying action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19 _Pay 19_
Lesser of 1/2 Homestead
S
Valuation or $2,000
Signature of Auditor Date signed