Homestead_Smerchek SAVE FORM!3:+9 IIC,S-0'1 TSLASUara FORM S5-1A
APPROVED BYSgtr BOARD OF nn4wtSmI rRIsmPEw BY Tim DEPARTKE`ITrf LOCAL Cdw[RNMEM PO:ANCE IC 4-1.1--r-1.l
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETO".I IN 47670 Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becontes
more beneficial,there is more incentive than ever for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
II e - HEA 1344-21109 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
61ingg.this information will be kept confidential and an only be accessed by authorized county officials.The Depanntent of
Local Government Finance will tor this information to create tools that will help county official,eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Smerchek, Cleat L
el
• Box 296. 6 CU
Oak •I 'tv IN47660 /j,U 6°
\
1861 J U
Cleat L Smerchek t32' p [Loy C \
O2-Box 96 A State Parcel Number Legal Description
Oakland C_4.7666
26-14-06-200-000.649-006 003-00649-00 PT N NE 6-2-8.483 AC
111u 11x11 11u t111t 11nuI,Itut11J.Iu11utt11111tnuIuIt1 C-1
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 INFORMATION
Owner I First Middle Last
G LEA-r- LEE I�I SNICKCN6k
g Address(number and sftth,eilv,state,and ZIP code) rx/r Same as progeny address
132-o NJ IZOO e 0A-K-L-noun ctrKJ IN L-E"76, Lio
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as progeny address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Pan 4 below)
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
yP�CLAIM-FOR HOMESTEAD PROPERTY TAX FORM YEAR
4 CREDIT /STANDARD DEDUCTION HC10
State Form 5473 (R2/5-92)
rm
INSTRUCTIONS: See reverse side for filing instructions.
I r1Ne - certify that on the 1 st day of March, 19
occupied as our principal place of residence t `` ollowing described real property for which a Homestead Property Tax Credit is hereby claimed:
V) I (We) owned ❑ Are buyir�1rr18efcontrAc - I
❑ Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is buy __V1*aWntraV
CONTRACT RECORDED
If burying on contract.. Fee Simple owner's name OC 7. 1996
Recorder's office where contract is recorded Recor Page
-
PROPERTY DESCRIPTIO
County
Township
NON - RESIDENTIAL
VALUE
Taxing distri (cir , town, t nshi )
p rc 1 number
Legal description
�-_ 0 0
�_
Other land
ob
_
Total land (line 1 plus line 2))
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.
Residential improvements
- PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County Township
Township
HOMESTEAD
VALUE
NON - RESIDENTIAL
VALUE
® =_by certify the above statements are true, correct and complete. Signat re o laimaor
1
Address (number and street, city, state, ZIP code)
2 X0 2 9 6 a Z-A-. - o W 7 4 6 a
ASSESSOR USE ONLY -
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON - RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Valuation or $2.000
Signature of Auditor
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 pbs line 7)
(6)
I hereby Certify the above is true, correct. and
complete.
Signature of Assessor
Date signed
ing action - Signature of Auditor
Date signed
_ STANDARD DEDUCTION ALLOWANCE
19 —Pay 19_ ,
Lesser of 1/2 Homestead
S
Valuation or $2.000
Signature of Auditor
Date s ned