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Homestead_Mason SINE lOAM 5l!MIR_-/aul TRUSULEA mzN SIA .APPRf1:ED BY Mil Bnotoof MTnL\Tl Ztn, PIrs,JBED BY TIC DEPAR1MLYr OF L(*AL rawrLNMrwT FINANCE IC.I.1-_at 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 ever for homestead fraud.Homestead fraud causes higher tax bills for all:therefore. II HEA I344-2009 requires taxpayers who receive the homestead standard deduction to verily that they are eligible to recehe the benefit and to provide additional identifyine information necessary to allow county government to better monitor homestead filings.This information will he kept confidential and can only lv 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 Pronertv Address Mason, Thomas W/Georgian R I Box 2444 ?-1.G . Oakland City IN 47660 / 4414 n /)J 6 Thomas W/Georgiana Mason \a' R 1 Box 244a State Parcel Number Legal Description` OAKLAND CITY IN 47660-8404 1r1 26-13-15-400-000.991-006 003-00991-00 PT SE 15-2-93.32 AC n��nr�t��tu��u��nt�n�n�n���u n�n��nt�trt��rt��r� D-6 C-1 PART 2: TAXPAYER INFORMATION Owner I First Middle Last I-10N1A5 0 ro ASO I-) alAddress(number and strmet,city,state,and ZIP code) —. . .__ --- — ® Same tLS property address -- -- — — (-( 911E Ia5 c3 ceteitop cry Lfr1tceo Spouse First Middle Last C9a* 0 — mn-391-) Mailing Address(Number and street,city,state,and ZIP code) © Same as property addro5 g3gq E last S DA B C.'Ty sx) 1-410bo PART 3:CERTIFICATION Each undersigned certifies,under penalty of perjury,that the above and foregoing infonnation 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. O..nei attuuree1�J�/ Date shalt III iCLAIM FOR HOMESTEAD PROPERTY TAX CREDIT /STANDARD DEDUCTION State Form 5473 (R2 15-92) s INSTRUCTIONS: See reverse side for filing instructions. YEAR CERTIFICATION STA M NT FORM CONTRACT RECORDED HC10 Recorder's office where contract is recorded Record number q YEAR CERTIFICATION STA M NT I (We) certify t at ;he 1st y o arch. I (We) occupie as our principal place of residence the followi ascribed real property for which a ea reby claimed: ❑ 1 (We) owned ❑ Are buying under contract . ' i!?SON COUK I aL'DITOF ❑ 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 If buying on contract. Fee Simple owners name Recorder's office where contract is recorded Record number Page PROPERTY DESCRIPTION County Township Taxing district (city, town, township) P cel num er 0.9°g1- - Legal description 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. PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES County Township �ereby ertify the above statements are true, correct and complete. County Township Si ure f claimant A re (number and street, city, state. ZIP code) ASSESSOR USE ONLY TRUETAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON- RESIDENTIAL VALUE Land not exceeding 1 (one) acre immediately surrounding residential improvements. (1) Other land (2) Total land (line 1 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 plus line 7) (8) 1 hereby certify the above is true, correct, and complete. Signature of Assesor —rate Date signed Verilymg action - Signature of Auditor STANDARD DEDUCTION ALLOWANCE 19_ Pay 19 Lesser of 1/2 Homestead Valuation or 52,000 $ Signature of Auditor Date signed