Homestead_Maier STATE I ORM!3"..ocr HN1 TREASuLER FORM 11.1A
APPROVED BY SIAM.&WOOF.STRINTS.1a PL6[WBm BY 111T DEPARTMENT(*LOCAL GOVERNMENT FINANCE K'VI.1-:'4.1
Gibson County Auditor
101 NMain 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 ever for homestead fraud.Homestead fraud causes higher tax bills for ail:therefore.
HEA 1344-2000 requires taxpayers who receive the homestead standard deduction to verily that they are eligible to recene the
benefit and to provide additional identifying informavon necessary to allow counts'government to better monitor homestead
filinfs.This information will he kept confidential and can only be accessed by authorized county officials.The Department 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
Maier, Wilma Lee
RI Box 182 B
Oakland City I�tr47660
118 v
Wilma Lee Maier
8997E 360 S State Parcel Number Legal Description
Oakland City IN 47660-8406
26-13-34-100-000.526-006 CC0�00526-0O PTENW 34-2-92.26 AC
This form MUST be returned to Count y Auditor's office.
Please do NOT send this form back with your tax payment to the county treasurer.
• PART 2:TAXPAYER INFORMATION •
Owner I First Middle Last
e e fl'l cis cr
•tg Address(number and street.city,state,and ZIP code) Same as property address - — —
t997e. 3405 Oak /ark. C';fll, S.- • 1176so
Spouse First Middle Last
Mailing Address(Number and street,city.stale,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 4 below)
sme
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
.4-
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Form 5473 (R2/1.90)
INSTRUCTIONS: See reverse side for filing instructions. .
j
CERTIFICATION STATEMENT
FORM YEAR
HC10
I (We) certify that on the 1st day oft 8th? ]�9)qL
I (We) occupied as our principal place of residence the following described real property for which a Homestead
erty Tax Credit is hereby1claimed: Q 1 (We) owned ❑ Are ATrg,,V /�yyf C61 l
W W tII.111 I V
Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the
Fl property or is buying it under a contract.
CONTRACT RECORDED
If buying on contract, Fee Simple Owner's Name
I;l
Recorder's office where contract is recorded
Record Number
Page
't ,
I
h „ess (Street, number, city, state and ZIP code)
Lesser of 1/2 Homestead
III
PROPERTY DESCRIPTION
County
Township
li'
Taxing Dist r' t (C' , town, t nship)
Parce Nu{j�,�b
-CJt�� o� (D –
Legal Description r ^ l 1 ^� I I –A—ci P�
1101: J r-1 la
If any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that struc-
ture is used to produce income describe the use and portion of the property utilized to produce income.
— 3 '
I!
PROPFRTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
Township
County
Township
I hereby certify the above statements are true, correct and
fete.
ignature c Y
h „ess (Street, number, city, state and ZIP code)
ASSESSOR USE ONLY TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements
Other land
Total land - line (1) plus line (2)
Residential improvements Dwelling
Garage
Other improvements
Total improvements - line (4) through line (6)
Total value - line (3) plus line (7)
(1)
1991 Pay 1992
19 —Pay 19-
®ser of 1/2 Homestead
(2)
Lesser of 1/2 Homestead
Lesser of 1/2 Homestead
Valuation or $2,500
(3)
Valuation or $1,500
Valuation or $1,500
(4)
,
(5)
Date.Signed
_
(6)
(7)
(8)
1 hereby certify the above is true,
correct, and complete
Signature of Assesor
Date Signed
Verifying Action - Signature of Auditor
Date Signed
CTArdnAnn nrnlirTInN At I OWANCE
1989 Pay 1990
1990 Pay 1991
1991 Pay 1992
19 —Pay 19-
®ser of 1/2 Homestead
,: Lesser of 1 /2.Homestead
Lesser of 1/2 Homestead
Lesser of 1/2 Homestead
Valuation or $2,500
i i j Valuation or $2,000
Valuation or $1,500
Valuation or $1,500
ul
,
Signature of Auditor (�
Date.Signed
_
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