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Homestead_Epperson (2)CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT /STANDARD DEDUCTION State Form 5473 (R614 -03) Prescribed by the Department of Local Government Finance INSTRUCTIONS: See reverse side for filing instructions. FORM YEAR _ I �HatD ETA JL JLJ yLJ APR 5 2007 I (we) certify that on tfit y of March 20 r I (We) occupied as our principal place of residence the following described rea property for which a Homestead:Qraperty' TaxlCreiiit i�hereb�daimed: l(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. ' .f"a- .Y;r.�i If buying on contract, Fee Simple owners name Recorders oft ce where contract is recorded Record number Page .- -- rt's-= .`tR.?rc - is`'.�'�'i?.P+`y+t!�..si. " V' r�w1P.ROFERTY,DESCRIPTION - -:• ' X �rY 3 County 7avnship Twin district (city, town, township) Parcel number a4-f9- 31- 400 -oo0, `7o5 -co descd Le al 9 P j n n / V Is the property in question: 'Real property ❑ Mobile Homo (I.C. 61.1 -7) H any portion of the residential structure or the land not exceeding one (1) ace that immediately surrounds that structure is used to produce income, describe the use and portion of the property utilized to produce income. P ��+ ��'te� %�P ROP- E.R..T_ Y,O.. W - N ED_ ' BY . . CLAIMANT-IN CI TH_ ER. 'COUTIES County Toxnship County Toomship hereby certify the above statements are true, correct and complete. S(gnatur laima t dress (number and street- c' , ate, ZIP code) t„��' SSESSOR US ON Y I2?�rifiUEaTAX'� . sLr. K"."1.,-+i_8f31rS_:!- �'r� -"'.ss s6g..'Tc- . VALUE -. r SSESSED VALUE AT.100% OF'TTV*�VALUp"{SL�; ''iHOMESTEAD }` `�NON�- RESI➢ENTIAL VALUEi,�.��y Land not exceeding 1 (one) acre immediately surrounding residential improvements. -- qij Other land i.`�'�- (2)- Total land (line 1 plus line 2) (3) v.- ME Dwelling (4) PY Residential (Residential Improvements or Annually Assessed Mobile /Manufactured Home Garage (5) Other improvements (g) Total improvements (line 4 through line 6) (7) Total value (line 3 plus line 7) (6) I hereby certify the above is true, coned, and Signature of Assessor Date signed complete. Verifying action - Signature of Auditor Date signed 20_Pay 20_ Lesser of 112 Homestead Valuation or 835.000 signed • AVIE FORM 37.e./i,rvl f EASUlG FORM 31A APPROVED BYSISIE nnuonram.nsts.am PrinamnY nit DEPAIMFE4TOF LOCAL rognorerNT FINANCE IC 4_I.I-224.1 Gibson County Auditor 101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS PRINCETON IN 47670 Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes more beneficial.there is more incentive than ever for homestead fraud.Ilomesread fraud causes higher tat bills for all:therefore. HEA 13-14-2009 requires tavpayen who receive the homestead standard deduction to verify that they are eligible to reecho the benefit and to provide additional identifying infon nation necessary to allow county government to better monitor homestead filings.This infnrnuition will he kept confidential and can only be accessed by authorized county officials.The Ikpanment 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 Epperson, David A/Paula M 20441 Old Princeton RD Ilaubstadt IN 47639 8301 David A Epperson 201 S 6th State Parcel Number Legal Description HAUBSTADT IN 47639-8212 26-19-31-400-000.705-009 013-00705-00 BRIARwOOD 10 llI nIIll lIllluulll IIlululntltl utll ullI II 1111..11 A PART 2:TAXPAYER INFORMATION Owner I First Middle Last All AI leA/ tg Address(number and street,city,sate,and ZIP code) - - R.—Fee pm driv — _ _ 10i S r 6 � 4s-& W TA/ 'f76 3�°"," Spouse First Middle Last vPALL/ Y4 Mite E EPPE So ki Mailing Address(Number and street,city,state,and ZIP code) ESune as property address 0701 �. L* A kJ E //ASTir► 0 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. Own< I Signature Date