Homestead_Davis (2)CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
x CREDIT /STANDARD DEDUCTION u
` State Form 5473 (8817 -07) (L
Prescribed by the Department of Local Government Finance \ i.,
INSTRUCTIONS: See reverse side for filing instructions.
CERTIFICATION STATEMENT
I (We) certify that t� arch, 20_
1 (We) occupied as our ri 'pal place of residence the following described real property for which a Homestead@9 t i pp�� cialmed:
�U1OR
Cave(We) owned E] 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.
CONTRACTRECORbED
If buying on contract, Fee Simple owner's name
Recorders office where contract is recorded Record number Page
County
B6dx ,
PROPERTY
Township Tarz'vig d'
(city, to ,township)
Parcel number
L escription
Is the in Ibn:
0(l
LA4 /
Real property ❑ Mobile Home (IC 61.1 -7)
If arty porno a residential sbucture or the land not ing one (1) acre that immediately su
s that structure is used to produce Income, describe the use and portion
of tits props 'lized to produce income.
/6[Ce a /
43,000 for 2009 pay 2010
�'' ` % - - -' `� `' V_ •� - '
ASSESSOR USE ONLY
TRUE TAX-VALUE
JASSESSEDVALUE1
HOMESTEAD
NON-RESIDENTIAL
.
42,000 for 2010 pay 2011
AT 100% OF TTV
VALUE
VALUE
Land not exceeding 1 (one) acre immediately
s
Homestead Valuation
0
43,000 for 2009 pay 2010
�'' ` % - - -' `� `' V_ •� - '
surrounding residential improvements.
Signature of/wdtor
to signed (mcwlh, day, year)
r:
Other land
(2)
- -
:Y
Total land (line 1 plus line 2)
(3)
'h'frs�
Residential improvements or Annually
Dwelling
(4)
Garage
Assessed Mobile / Manufactured Home
(6)
Other improvements
(6)
Total improvements (line 4 through fine 6)
(7)
Total value (line 3 pits fine 7)
(8)
hereby certify the above is true, correct, and
Signature of Assessor
Date signed (manlh, day, yead
complete.
Verifying action - Signature of Audtor
Date signed (month, day. yam)
STANDARD DEDUCTION
20 _ pay 20 _
46,000 for 2007 pay 2008
42,000 for 2010 pay 2011
Lesser of 1/2
44,000 for 2008 pay 2009
41,000 for 2011 pay 2012
s
Homestead Valuation
0
43,000 for 2009 pay 2010
40,000 payable after 2012
"
Signature of/wdtor
to signed (mcwlh, day, year)
•
atArE FORM!)lt"IR_/lwt t!risutut AY.V 73-IA
•NRrn'Eo BYSPTE BOARD OFARx1sTS.low rtFAWBW BY TIM DERARTME4T Cr LOCAL rK ?RNMENT rnASCE tr H.I_EI
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 becomes
_ more beneficial.:herr is more incentive than e'er for homestead fraud Homestead fraud causes higher tax bills for all:therefore.
• HEA 1344-21X/9 requires taxpayers who receive the homestead standard deduction to verify that they am eligible to receive the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.ibis information will be kept confidential and can only be accessed by authorized county officials.The Ikpanntenl of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART It PROPERTY INFORMATION
Taxpayer Name Property Address
Alston, Bryce S/Elizabeth K
- - _ _ _ . - ___ __ I19N Vine St _ , ... .
Ilaubstadt IN 47639
3079
Stacy L Davis
119 N Vine St State Parcel Number Legal Description
HAUBSTADT IN 47639-8122
�t�tt��ttr�t��tttt��111�lilItl IltIl�I lltlltllltllt��IlIilltllI 26-19-31-301-000.241-009 013-00241-00 ORIGINAL PLAN 125PT/126
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 y First Middle cc CC Last
tress(numb, az street,city,state,and ZIP code) a Same as property address
11° N \ . c 5�
Social S'e'cure y Number
/r((last 5 digits) Drivveer'ss License/State ID Number (last 5�ddiiggiits) Other(please specify in Pan 4 below)
irst Middle Last
Mailing Address(Number and street,city,stale,and ZIP code) IJ(Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
Sox-
PART 3:CERTI -ICATION -- '— ' '
• 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 Telephone r l
Spouse Sigllamre Date Telephone r l
PART 4:ADDITIONAL INFORMATION
0