Homestead_ColemanCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
Gbh • State Form 5473 f R2 / 5-92)
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INSTRUCTIONS: See reverse side for filing instructions.
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_ >Y
CERTIFICATION STATEMENT
OJe) �_(_ %�)
I ' 01ho 1st f arch, 19
occupied as our principal place of residence the fo owing described real property for which aesteai g reby claimed:
I'X 1 (We) owned ❑ Are buying under contract SO
❑ Have a beneficial interest in the entity that is liable for the property taxes on the property and t the propert y or is buying under a contract.
CONTRACT RECORDED
It buying on contract, Fee Simple owner's name
Recorders office where contract is recorded Record number Page
` PROPERTY DESCRIPTION
County
Township
Taxing district forty, town, township) y,
Parcel�umDer �o
Legal description ) [j _ D
If any portion of the residential structure or the land not exceeding one (1) acre that immediately s r unds 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
®eby certify the above statements are true, correct and complete.
Signature o mant
Address (number and street, city slate, ZIP code)
ASSESSOR USE ONLY
TRUETAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON -R IDENTIAL
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 plis line 7)
(g)
1 hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
-.W" ng action - Signature of Auditor
Date signed
19_Pay 19_
Lesser of 1/2 Homestead
Valuation or S2,000
of
S
ALLOWANCE
-
J
STATE rrM4555 Ill!✓.M, TREASURER MIN 75-In
APPROVED BY aroi NNRDrf ACMeT[_nh PUUYTIDrD BY TIr DEPARTMENT OF L 1 rennoe rNT FN.4SefW 6-I.122J.I
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to orr homestead standard deduction.As the receipt of this deduction baunies
more beneficial.there is more incentive than eser for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
® HEA 1374-2009 requires taxpmcrs who receive the homestead standard deduction to verily that they are eligible to Teethe the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
lilingv.This information will he kept confidential and can only he accessed by authorized county officials.The Department of
Local Government Finance will use this infomwtion to creole 40l5 that will help county officials eliminate lxmnes:cad fraud.
PART I: PROPERTY INFORMATION
Taxpayer Name Property Address
Coleman, Harold L/Sharon L
901 W Gibson
Ilaubstadt IN 47639-8156
7276
Harold L/Sharon L Coleman
901 W Gibson State Parcel Number Legal Description
HaubstadtIN 47639-8156
lllllllllllllllllllllllllllllllllllllllltrllrtll lIlltrtl 26-18-36-401-000.620-009 013-00620-00 WEST HGTS 4TH ADD 30
PART 2:TAXPAYER INFORMATION
Owner I First Middle Las(
/beat/J G.EE
rg Addn s(number and street,city,state,and ZIP code) cur.Barre as property address -- - -' -
�O/ CA- S !/f3.5 74/9.014,-- its 47Z- 3 7
•
Spouse First Middle
Last
■ )1174/e041 . CC nn`OGe w /A/
Mailing Address(Number and street,city,state,and ZIP code) E'Same as pmpeny address
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 Signe • e Date
,
PART 4:ADDITIONAL INFORMATION
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