Homestead_BuckCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
N State Form 5473 (R614-03)
Prescribed by the Department of Local Govemment Finance
INSTRUCTIONS: See reverse side for riling instructions.
001-004144, Is a AWIR
FORM YEAR
.J J — certify that on the 1st day of March, 20_
real property for which a Homestead Property Tax Credit Is hereby claimed:
owned ❑ Are buying under contract
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.
-xVNW'� CONTRACT-,RECORDED'
If buying on comract, Fee Simple owners name
Recorder's office where contract Is recorded Record number Page
---PROPERTY OWNED'BYCLAIMANT,IN'OTHEkrCOUNTIES��" '.,. ". -., +., -,� "'
County
Cxxinty
I
Township
Taxing a town, tcn,mv,
I Lq _nje-s2k
I hereby certify the above statements are true, oomact and complete.
Parcel number
6 v�n — Wo
descri lion
I 11�W 0
is 1haPrcq;X rty in question:
1 Meal PropeL)
❑ Mobile Home (LC. 6-1.1-7)
If any portion of the residential sWdure or the IoM not exceed one (1) am that immediately wrtounds Na Uure Is used to produce Income, describe the use and P;7w
of the property utilized to produce income.
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---PROPERTY OWNED'BYCLAIMANT,IN'OTHEkrCOUNTIES��" '.,. ". -., +., -,� "'
County
Township
County
Township
I hereby certify the above statements are true, oomact and complete.
Signature of claimant
M (number and street, city, state, ZIP code)
0w 4
'T RUE TAVL.,
Agidsk-iV E
HT -..`
ti "* ANON -RESIDENTAL
,
r, Z� UqP5
– R
T100%OFjTTV�VALUES`'`O.
Date s' ed
Land not exceeding I (one) acre immediately
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surrounding residential improvements.
Other land
(2)
Total land (line I plus line 2)
(3)
Dwelling
(4)
4• i7i
Residential improvements or Annually
Assessed Mobile I Manufactured Home
Garage
(her improvements
Total improvements (line 4 through line 6)
(7)
Total value (fine 3 pits line 7)
(8)
I hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete. -
Verifying action - Signature of Auditor
Date signed
`STANDARD DEDUCTION ALLOWANCE'
14111111IF 20_ Pay 20_
Lesser of 112 Homestead
Valuation or $35,000
Signature of r
Date s' ed
42M
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% rirIEFORM,3sa i0._ruwt M IPFANaUA FORM:11.E
,PrM''Eo BT Sisal BlVNm''CILT5_`u 'PLESCMBED BY lilt DE?A HEST OF LOCAL GM'E0..YMTh FINANCE IC 4-1.1.2:4.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead.,undatd deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than e'er for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
0 HEA 1344-2009 requires tarpapers who remise the homestead standard deduction to verify that they are eligible to recehe the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This infomunon will be kept confidential and can only be accessed by authorized county officials.The Ikpanntent of
Local Government Finance ss ill use this information to create tools that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION
Taxpayer Name Property Address
- _ Buck, Wayne A/Tara L
PO13ox 125
' Mackey IN 47654
3262
Wayne A Buck
109 N Division State Parcel Number Leaal Description
MACKEY IN 47654
26-20-14-103-000.064-002 015-00064-00 PT SW NW 1439.27 AC
This form MUST be returned to County Auditor's office.
Please do NOT send this form back with your tax payment to the county treasurer.
PART 2: TAXPAYER INTORMATION
Owner I First Middle Last
WC_velF A 13.. uCk
'rig Address(number and street.city,state,and ZIP code) ❑ Same as property address
to ci L a- 5 . D i.L jai .S-1 • Calderoal 6/it .Grr cif 7c ro
Spouse First Middle Last
ac c1/4--. L 3A,xcK
Mailing Address(Number and street,city,state.and ZIP code) [] Same as property address
(9443. S5 D,e aisZor-s S+ l,t.lo-,,,c( C(}Y yes V7 6(.o
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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 Signa c Date
PART 4:ADDITIONAL INFORMATION
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