Homestead_AllenCLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
d, CREDIT /STANDARD DEDUCTION - HCtO jms
State Form 5473 1132 15-92)
INSTRUCTIONS: See reverse side for filing instructions.
r:FRTIFI(:ATIf1N CTATFMFNT - -
I (We) �(y/Y /L�%)'i,(t�S,.i l.('Q/1� certify that on the 1st day of March, 19D
I+ i4We) occ ie as princip place of residence the following described real property for which a'Homestead Property Tax Credit is hereby claimed:
(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 -
Recorder's office where contract is recorded Record number Page
PROPERTY DESCRIPTION -
County
Township
Taxing district (city, town, township) ,
Parcel number
Legal description /� ///// //,v
If any portion of the residential structure or the land not exceeding o e (1) acre that i ,ediatety 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 COUNTIES
County
Township
County
Township
. I hereby certify the above statements are true, correct and complete.
Signa re claimant
ss (number and street ary, state. ZIP code)
WFA
ASSESSOR USE ONLY
TRUE TAX
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 I 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 plrs line 7)
(g)
1 hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
Verifying action - Signature of Auditor
Date signed
19_Pay 19_
Lesser of 1/2 Homestead
Valuation or $2,000
Signature of Auditor
S
ALLOWANCE
I��— / /'b � It
e staCVOIN!;t iC/!rr'I IREAN[ER FORM tSIA
VYWn'ED BY CIATE BDeRD(IF ACrI \'1 a.9• PRIAWam BY no.DEPARTOGOf LOCAL CM2RVMnr rAlrCE IC H.12'-RI
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individual and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
• more beneficial,there is more incentive than eser for homestead fraud.Iomestead fraud causrn-higher tax bills for all:therefore.
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to serif y that they are eligible to receue the
benefit and to provide additional identifying informnwn necessary to allow county government to better monitor homestead
filings.This information will he kept confidential and can only be accessed by authorized count'officials.The Depanntent of
Local Government Finance will use this information to create nvls that will help count:official..eliminate homestead fraud.
PART 1: PROPERTY LNFORMATION
Taxpayer Name Property Address
Allen, Jeffery D/ Ramona A
P 0 Box 16
Mackey IN 47654 /
8675
• Jeffery D/ Ramona A Allen
P O Box 16 State Parcel Number Legal Description
Mackey IN 47654-0016
ItIttIIrrrItllsrtlt1rr1rt111r rt11 11111 11t11tt11t tt1 26-20-15- -000.014-002 015-00014-00 MACKEY ADD N12 OF
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
ecfr D Iles — —
�g Address(numbs. d street,city,st te.and ZIP code)
� /,- - --- n Same as property odaiS / ,J — ' --z/Sr figrjey
Spouse First Middle Last
air OpOsai 0 • z 4 1l esn
Mailing Add (Number and street,city,state.and ZIP cote) Same as property address
PQ6ox/Cr 19)(tee ecilf J 5t7(059
Social Security Number(last 5 digits) Drivtyi License/Sta ID Number (last 5 digits) Other(please specify in Part 4 below)
cJ3739 s. 0 to 049
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 D .� Date /
PART 4:ADDITIONAL INFORMATION
IP