Homestead_GriesCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
r °r , State Form 5473 (R5/ 10-01)
Prescribed by the Department of Local Government Finance
FORM YEAR
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I (We) t rLo �f . C%y M. - - - certi&.1 t'bmthe- i5tday�ot,Marc�f
�IRW �cC.e Credit (We) occupied as our principal pla�e of residence the following de cribed real property for which a Homestead Property Tax Credit is herellydaimed:
(We) owned El 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.
NTRACT. ?R
ECORDED
If buying on contract, Fee Simple owner's name
Recorders office where contract is recorded Record number Page
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- sass..,. r; 3PROPERT .I'.6ESCRIPTI6N€�.,,�a_.__,a`
County
To+nship
Taring district (city town, township)
Parcel num r
Legal descnp'
Is the property in question:
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Real Draperty ❑ Mobile Home (I.C. 61.1 -7)
If any portion of the residential structure or the land not exceeding one (1) acre that Immediately surrounds that s re R used to produce income, describe the use and portion
of the property utm7ed to produce income.
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_•.,-�- ,�uin¢g�,!,:;}�s�,��. -. ,sPROP.ERTY, OWNED; BYCL' AIMA!!C!IN;OTHER.000NTIESJtvba_ �i,`'�ca� �'S*�
County
Tmnship
County Township
I hereby certify the above statements are true, correct and complete.
Signal of claimant
Address (number and street, city, state, ZIP code)
is r-
-
ONLY�V'•�'aVALUE"'F`'
TRUEaTAXs �
ASSESSED VALUE
"`AT
aHOIAESTFJID
-,
" IWO
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_ASSESSOR'USE
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100 ° /dOFTfY
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VALUEf
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FNON VALUE�'E
Land not exceeding 1 (one) acre immediately
- a- '+�`_d.'=
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surrounding residential improvements.
Other land
nc.y stn
Total land (line 1 plus line 2)
(3)
Dwelling
� s l
�'.��
(4)
.fin Uk5M �'s� NA
'`°' `�`'
Residential improvements
Garage
6
t ° d
Other improvements
(6)
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Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(6)
1 hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Data signed
0M2�, , �._ -,oElt��5zv+- ac�,...�_°,r"�. STANDARD: DEDUCTION;ALLOWAMCE
Ir :` �w�smu- �L- z,:sX•+�..;A��at ='�r:.
20 _ Pay 20
Lesser of M2 Homestead
Valuation or $6,000 $
Signature of Auditor DatetIgned
AR..1t..J l '. � `
STATE FORM:WM tin...I MEASURER FORM ARIA
APPROVED BY STATE M5ARIMNTYR:V1S.'_tM PRr]TAIOID BY nM OPPMnWNT OE LOCAL GOVERNMENT FINANCE M 6IAn-r.l
Gibson County Auditor S IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
NMain
PRINCETON IN 47670 Individuals and married couple are limited to one homestead standard deduction.As the receipt of this dedtlttion becomes
more beneficial,there is more incentive than no'for homestead fraud.homestead fraud causes higher ta'bills for all:therefore.
• HEA 1344-2009 requires taxpayers who remise the homestead standard deduction to verify that they are eligible to receive a 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 hy amhnrieed enmity officials.The Department of
Local Goverment Finance will use this information to create tools that will help county officials eliminate homestead fraud.
-- , .PARTd:'PROPERT]=INFORDL►T1ON,._= . ___
Taxpayer Name Property Address
_ Gries, Dana T
R 2 Box 386
Ilaubsmdt IN 47639
P.
3066
Gries
305E Gibson State Parcel Number Legal Description
HAUBSTADTIN 47639-8203
II III II I I I I I III II II I I III 26-19-31-300-000.181-009 013-00181-00 PT SW 31310.32AC
ru urn nu r rnnnt t t tot rut t
This form MUST be returned td E unty Auditor's office.
Please do NOT send this form back with your tax payment to the county treasurer.
PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
—b;an c..... —TG,a vex. Grr p.i_s
"kg Address(number and street.city,state,and ZIP code) 24rne as property address
3oc EGs) (7tvosw, 54- ) }la..L6.51FcLl- , To W1 3G5 - - - - -
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please sptcify in Part 4 below)
_ . _ sux. _.. - _--_
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.
Own I Signature Date
PART 4:ADDITIONAL INFORMATION
0