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(-TAIL FORM'J,*01:r',MI TRE•SUtaR FORM 11A
•
rIMPORTANT NOTICE TO HOMESTEAD FPROPERTY OWNERS
Gibson County Auditor
101 N Main
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 ever for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
• HEA 1344-2100 requires taxpayers who receive the homestead standard deduction to verity tat they are eligible to receive the
benefit and to provide additional identifying infomunwn necessary to allow county government to better monitor homestead
filings.This infmmatinn will be kept confidential and can only he accessed by authnrired count'of ctil .The Depanntenl of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
l PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Hill, Sharon S Life Est Etal
RI
ea-a . City IN47660
S
Sharon S.Hill— _ _
2649 S ST RD 57 State Parcel Number Legal Description
'OAKLAND CITY IN 47660-8423
r�rr��rrt�r��rrs��lr��rrr�tr�n t�r l�rl�t�tr��rs nt��r�rt�rr t11 26-13-26-200-000.530-006 03-00530-00 PT NE NE26-2-9.627 AC
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PART 2:TAXPAYER INFORMATION
Owner First A Middle Last
c
•Ig A d d r e s s(number and snaet,city,state,and ZIP code) - ❑ Same as property address- — — —---- ---
[d e tic?s , zakt t`R et 57 &4L-,.c2 -e / o .etc`ea-clo '`14766-
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 specify in Part 4 below)
sore
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.
I Sign Date��
•
E�n CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (R215 -92)
a
INSTRUCTIONS: See reverse side for tiling instructions.
FORM YEAR ,;
HC10 '
x-
I (We) _ __ �7 yv certify that n the 1st`dHay okVararc�.h, 19
a_) occupied as our principal place of rest a ce the following described real property for which a Homestead PP,Cfpdibr�s{iergpy claimed,
IJ I (We) owned ❑ Are buying under contract IJUI I lJ�
0 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
Recorder's office where contract is recorded Record number Page
PROPERTY DESCRIPTION
County - Township Taxing district (olg town, township)
Parcel number - — Legal description
- oo.53b � a- P _ _
It any portion of the residential- structure or the land not exceeding one (t) acre that immediately surrounds that structure is used to produce mcome, describe the use and portion
of the property utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES -
County
Township
C r Township
®rebycertify the above statements are true, correct and complete.
Signature of claimant
elf
Address (number and street, city. state. ZIP code)
A
STANDARD DEDUCTION ALLOWANCE
TRUE TAX
ASSESSED
HOMESTEAD
NON - RESIDENTIAL
ASSESSOR USE ONLY
VALUE
VALUE
VALUE
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Other land
(2)
Total land (line I plus line Z)
(3)
Dwelling
(4)
Residential improvements
Garage
(5)
Other improvements
(6)
J
Total improvements (line 4 through line 6)
(7)
i
Total value (line 3 pius line 7)
(g)
1 hereby certify the above is true, correct, and
Signature of Assessor
(Date signed
complete.
Verifying action - Signature of Auditor
Date signed
I
A
STANDARD DEDUCTION ALLOWANCE
19_Pay 19_
Lesser of 112 Homestead
S
Valuation or $2,000
Signatuff�RR''Q�)f Auditor
Date signed