Homestead_Garrisonr CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (8614 -031
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing insfmcfions.
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YEAR
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County
l 1`,
I (We)
Taring district (city, town, fwnship)
at on the 1st day of March; 20 tP
Le
I (W upied as ur principal place of reside ce the following described real operty for which a Homestead Property Tax Credit is hereby daimetl:J
Is the property in question:
❑ Real ro
p perry ❑Mobile Homo (I.C. 6-1.7 -7) .
VALUEf
'e-ue
I (We) owned ❑ Are buying under contract J U iV i i 2004
Land not exceeding 1 (one) acre immediately
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
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(1)eC'
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rr ��i�'� -` CONTRACT; RECORDED3�", �r' �, a?�,,.'^. �a`. �K� 'u��i�.�tii�'ra`u2�+P?�7i1H31
If buying on contract, Fee Simple owners name
Otherland
Recorders office where contract is recorded
Record number
Page
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County
Township
Taring district (city, town, fwnship)
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Is the property in question:
❑ Real ro
p perry ❑Mobile Homo (I.C. 6-1.7 -7) .
VALUEf
'e-ue
If any po ien of the residential ,s-Wcture or the [and not ex eeding one (1) acre that immetliatey surrounds that structure Is used to produce income, describe the use and portion
o01 pr 7 17coincome.
�D
County
certify the above statements are true, correct and complete.
city
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UvASSESSOR,USE ONLY '�"
'TR EU TAXI
°,,�`S�4�4.VALM'
ASSESSED VALUE
HOMESTFADD.-
r O - RESIDENTIAL �+.
£"{�.'•p,{SU- Lli}p..F: fiife�rr�i3ri
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i42atr .�_...JS'�..r.
AT 100 %OFTYV
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VALUEf
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+ ,f VALUE
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Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)eC'
sor''`t Y
Otherland
(2)°
='�z3
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
rJ't"�.i�
Residential improvements or Annually
'^¢'F" 2
Assessed Mobile / Manufactured Home
Gara e
9
(5)
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_4
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A - N,'it 'a-&
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m
Other improvements
(6)
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Trial improvements (line 4 through line 6)
(7)
Trial value (line 3 pits line n
(6)
hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
qWMME `STANDARD: DEDUCTIONALLOWAHCE
W 20 _ Pay 20
Lesser of 112 Homestead $
Vauatim or 535.000
Signature of Auditor D signed
STATE FORM 53569(R3,E-10) TREASURER FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS,2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMEet FINANCE'lC6I.1 22-B.I
IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
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. Homestead fraud
buses higher tax 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 necessary to allow county government to better monitor homestead filings. This information
will be kept confidential and can only be 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. l
'A' if PR'OPERTYINFORMA ION r
Taxpayer Name Property Address State Parcel Number`-\ Legal Description:
Jared Garrison 703 HAUB ST 26-19-31-400-000.748-009 BRIARWOOD SUB DIV II LOT
HAUBSTADT IN 47639 (.730AC)
Complete and return to: - - _I®110BEIRIIH Immmmu] ll! tU111E� _
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
. PART 2: TAXPAYER INFORMATION
Owner I First Middle last
SAeEO 1/4_1.5Ay1x ' GaRRc
Mailing Address(nwit r and streets city,state and ZIP code)
FA-Same as property address
7?3E Ft 1-10 I-a lalMeSnaeir a n La&.39
)Mitltlle Last
U\\ei,- `,3-JC1A9 c S xrt.Se-2
Marling Address(number and steel city,state and ZIP code) as property address .
703 C 4Abu(5
Each undersigned certifies,under penalty of perjury,that the above and foregoing information is true and correct and that he or sheds 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 Si sure Date
.. • - PART 4:*ADDITIONAL INFORMATION -r •
FILED
DEC 3°1 2012
GIBSON COUNTY AUDITOR