Homestead_Goldsberry •
Gull FotM.n ea de,w.t MIASMA mtMstA
APPROVED/1Y<T,1F.Ef1sRD of MTTR'.\tt l,N PRl3AIBmBY TIT 0FPARMENTOF LOCAL rnA'E4VMrgr FINANCE ML1.1-L'a.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 standard deduction.As the receipt of this deduction becomes
_ more beneficial.there is more incentive than ear for homestead fraud.Homestead fraud causes higher tat bills for all:therefore.
Me HEA 1344--7009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to leeehe the
benefit and to provide additional identifying information necrsary to allow county goern ment to better monitor homestead
filings.This information will be kept confidential and can only be accessed by authorized county officials.The Depanntent of
Local Guvamnent Finance will u<e this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Goldsberry, James E/
_ RI G /
_ OAKLAND CII IN 47660
--
_ --_ ,4887
James E Goldsberry
R 1 Box 183 A State Parcel Number Legal Description
OAKLAND CITY IN 47660-8402
IIIOIIIIIItlltttIIItlltt•lttltlltlll'null ltlttllttttliiiiiil 26-13-34-400-001.445-006 D-6 C-44 NW SE 34-2-91.97 AC
- X
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last o/isbrewnv
erg Address(number and street,city,state,and ZIP code) - _ - --- - - - -Same as prope oddrtss
9�/ dos - < ?i/ J
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 subst tial financial penalties.
Owner I Signature Date
ci // V /49, /Vt w bye / bt'iJ
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
\ State Form 5473(R614-03)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side Inr /i6nn invinrrnnn.
I (We) adw-Lwe �-L+ /
certif}
(We) occupi s our principal place of residence the following described real property which a Homestead
El (We) owned El Are buying under contract
U FORM YEAR
CIO
1iJ 1pbl
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.
. —Si l.°nx`i-�: ts,_ CONTRACT.! RECORDED:'�2s'�;,xu^3.z- .Fr:>; -tlr'
If buying on contract. Fee Simple owners name --ice2
Recorders office where contract is recorded Record number Page
sP,ROP,ERTY:DESCRIPTIONEM E% "`- ".'t 'L''.c ' -_ - �
County
Township
Taxis
Irict
Signature Iaimant
ress street. , state ZIP code) O
,
Parcel sum r
Legal descriplion Is the property in question:
'� HOMESTEAD
�4 .- �V_ALUEEY�t'.a�VALUE:+s?..
Real property ❑ Mobile Home (I.C. 61.1 -7)
If any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that subchrre is used to produce income, describe the use and portion
of the property utilized to produce income.
AIMAIN.'(5THER"000NTIES'c g?
c ?ROP.ERTY; OWNED; BYCL HT;
County
Township
County Township
hereby certify the above statements are We, correct and complete.
Signature Iaimant
ress street. , state ZIP code) O
.- ASSESSOR S ON Y } fir'-- .'vim,-;',
+ TRUE TAXI.' -tz+t-
ASSESSED VALUE
�AT 100 /a OFhTTV,*. t.
'� HOMESTEAD
�4 .- �V_ALUEEY�t'.a�VALUE:+s?..
r NON4MSI�ENT104
-t
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
== ?- _ g�,s,.,: -}-'
, '
Otherland
A
Total land (line 1 plus fine 2)
(3)
Residential improvements or Annually
Assessed Mobile If Manddectured Home
Dwelling
Garage
(4)
5
()
to
'�
' r4ia
0.4 ' - `" >}s " {.r.
Other improvements
(6)
i .. QTY
i.
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(3)
I hereby certify the above is We, correct, and
complete.
Signature of Assessor
Date signed
Verifying action - Signature of Auditor
Date signed
'STAN
DARD ;DEDUCTIONtALLOWANCE?'.s,:f ? -i *k,.'.i+�3_- .•,:.`b,��-
• 20 _ Pay 20 _
Lesser of 112 Homestead $
Valuation or E35.000
Signature of Auddor Date signed