Homestead_Bravo ' STATE Fai4!35t4 IRih-let TRASIRLR FORM T5LI
APPROVED B1 MIE BOWL,OF At rrk'NT.rye.+ MU4'RIIRD 111 Ott mfARIYkSI OF LOCAL COVER EtFi FL\&'4tiC bIl-U-s.1
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY'OWNERS" .
101 Main Street Individuals and married couples ale limited to one homestead standard deduction.As the receipt of this deduction becomes ,
In Princeton,ton, IN 47670 more beneficial.there is more incentive.than ever for homestead fraud.Homestead fraud causes higher tat bills for all:therefore.
' IIEA 1344-2009 requires taspaven who receive the homestead standard deduction to verify that they are eligible to recent the
benefit and to provide additional identifying inhumation necessary to allow county government to better monitor homestead
filings.This information will be kept confidential and can only be as-cssed by authorized county officials.The Department of
seal Government Finance will use this information to create took that will help county offcials eliminate homestead baud.
1 1 - PART l: PROPERTY INFORMATION -
Taxpayer Name Location Address
DEC Ci 2012 Bravo, Silverio
-+may\ 12289E HARRISON ST
c lYt4\ V \ OAKLAND CITY IN 47660
5458 IIII TTII
Silverio BravoGiBSON CDUNSY p0p1TDR 11111II_1III 1I1II 111 Bit iiBillIUII IOl BII�IIll11111Bi l ll liltBillIi.it II. II
12289 E HARRISON ST
Oakland City IN 47660-8100
II'lllIIIlll'IIIIII'II'I'III"I II'111"1 1111111111111111111111 State Parcel Number Legal Description
26-14-18-402-000.983-006 PT NE SE 18-2-8.35 AC C-1
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.
—__._,____ PART 2:TAXPAYER INFORMATION
.r I First Middle -- _- Last—
31 L\/ F V.1 a R '0., V0
Mailing Address(number and street,city,state,and ZIP code) 7.-4 Same as property address
Spouse First Middle Last
PP T 11 CI A ti\1-T1\--2_ -
Mailing Address(Number and street,city,state,and ZIP code) y�['I Same as property address
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. -
Owroer I $' Date
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (R215-92)
INSTRUCTIONS: See reverse side for tiling instructions.
fF RM YEAR
H616 199
- - / \UEHTIFICKIUN STATEMENT /,� _ _ .-
place of
certify that on the 1 st day of March, 19
property for which a Homestead Property Tax Credit is hereby claimed:
rrW(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 under a contract.
-- CONTRACT RECORDED
It buying on contract, Fee Simple owner's name -
Recorders office where contract is recorded Record number Page
`
PROPERTY DESCRIPTION - -
Gounty
Township
County
Tax' disc' t (city, town, township) -
Parcel number
not f claimant
escri do
1
3-00�� -cv
(2)
-.2-S 'a�zc,
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.
.
I
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
TRUE TAX
VALUE
County
Township
County
Township
�eby certify the above statements are true, correct and complete.
not f claimant
dress Inumbe street. city ar . ZIPCOde) -1V, //
Otherland
1
ASSESSOR USE ONLY -
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON - RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Signature f drtor Date signed
Otherland
(2)
Total land (line 1 plus line 2)
(3)
I
Residential improvements
Dwelling
(4)
Garage
(5) .
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 pfrs line 7)
(6)
I 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
Valuation or S2,000
S
Signature f drtor Date signed