Homestead_Williams STATE I ORM!!MI R=I),NI 1REAA1LEA FOBN TS-IA
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APPROVED BY AUF BOARD Of A C M.I N T S.9 x IRESLWBED BYnIr BEPAR➢es1-(F Lc L GOVERNMENT rINANCEMH.I-L-1.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples arc limited to one homestead standard deduction.As the receipt of this deduction benattes
more beneficial,there is more incentive than ever for homestead fraud.Homestead fraud causes higher tat bills for all:therefore.
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
benefit and to provide additional identifying information necessan.to allow county government to better monitor homestead
tiling..This information will he kept confidential and can only h 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
Williams, Daniel L/Peggy L
R3 Box 258
Oakland City IN 47660
5636
Daniel L/Peggy L Williams
12967E 150 S State Parcel Number Legal Description
Oakland City IN 47660-7843
I I I I III I I I I I I I I I I I I III I I I I 26-14-20-100-000.244-006 003-00244-00 PT NW 20-2-8 6.67 AC
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PART 2:TAXPAYER INFORMATION
Owner I First Lee Middle Last
�Flnie- I_ Lee I ; 14r--, S
g Address(number and street,city,state,and ZIP code) -\- _. Same as pro'pcerTty-(radius _e-1-- — — -_ - --- — -
0-'"1 (e7 E , Ise Sr �AJ8n 0) +4 -1�-LJ 17(.. D
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Spouse First Middle Last
qQ�\\ tt.�..�1�1 Lae I L L : 1`3 nn S
Mailin ddddrh(N bci .d street.city.state,and ZIP code) ® Same as property address
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.
4E R�
CLAIM FOR HOMESTEAD PROPERTY TAX.
a�
CREDIT /STANDARD DEDUCTION -
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State Form 5473 (R2/5-92)
Feu
INSTRUCTIONS: See reverse side for filing instructions.
FORM YEAR
FT'
MAY 0 8
CERTIFI TION STATEMENT ; / -
/wKe
I (We) - de yrt, advn -the ' t�li X (� of March, 19
occu ied as our principal lace of residence the following describe ' .LTV n
p p p p g perty for whit Ft?mesT9AdProperty Tax 'Credit is hereby daimed:
I(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 owners name
Recorder's office where contract is recorded Record number Page
" - PROPERTY DESCRIPTION
County
Township
County
Taxi9g-gistric (city, town, to7nshrpI -.
l/ �
Parcel number
=off
'tlescnptio
1141
-
If 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.
Otherland
(2)
' - PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES -
County
Township
County
Township
4jeby certify the above statements are true, correct and complete.
S' f claimant
Address (number and street, city, state. 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.
(1)
Valuation or $2,000
Si
Otherland
(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 pUs line 7)
(6)
I hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
Verifying action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19 Pay 19_
Lesser of 112 Homestead
S
Valuation or $2,000
Si
We of Auditor Date signed
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