Homestead_Houchins try:4 CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
s� CREDIT/STANDARD DEDUCTION HC1O
q� State Form 5473(R2/5-92) -.� i-a
.,. �1 , ;.
INSTRUCTIONS:See reverse side for filing instructions. •.-
• CERTIFICATION STATEMENT - _ - 1• 5 l �
r-
,1'We liUCC1,1 t',_ certify-that op t st da It oh, 19
i
occupied as our principal place of residence the following described real property for which a Homestead Pry) - t za•-reby claimed:
/ rff,-/j,( tUu.
I(We)owned ❑ Are buying under contract /j,tJ '`.,c,,o0-
❑ Have a beneficial interest in the entity that is liable for the property taxes on the properly and that ov/ns'theproperty or is buying under a contract.
CONTRACT RECORDED '
If buying on contract.Fee Simple owners name
Recorder's office where contract is recorded Record number Page
°' . PROPERTY DESCRIPTION
County Township Taxing district(city,town,tow ) •
s> D� ►3 PT /
(` 16 P --
Parcel number Legal description
0ao -000677-C1-.)
If any portion of the residential structure or the land not exceeding one(1)acre that immediately surrounds 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
illeby certify the above statements are true,correct and complete. na e of claimant-
ter /2
A..40 ss r tuber and et city,state.ZIP coder / a(,/
ASSESSOR USE ONLY TRUE TAX ASSESSED S HOMESTEAD NON-RESIDENTIAL
VALUE VALUE- I VALUE VALUE
Land not exceeding 1 (one)acre immediately
surrounding residential improvements. (1) ..
Other land (2)
Total land(line 1 plus line 2) (3)
Dwelling (4) '
Residential improvements • ,
Garage (5)
Other improvements (6)
Total improvements(line 4 through line 6) (7)
Total value (line 3 Ors line 7) (6) . -
I hereby certify the above is true,correct,and Signature of Assessor Date signed
complete.
-ifying action-Signature of Auditor Date signed
STANDARD DEDUCTION ALLOWANCE
19 Pay 19_
Lesser of 1/2 Homestead
Valuation or$2.000 S
Sign re of Auditor ,1a Date signed
gen a-1 4.120-1A
TAIL r[KKY!to lR I sWI rVAStI l rOtMSIA
ArPlaWED BY%TSTE BOARD OF Ann SMF.tU erfs,mm0Y i11f OEPARTWYTIW LOCAL f(KFLYMI'N'r FINANCE It'6-1.1-_r.l
0ounty Auditor
11 N "C Main M IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N
PRINCETON IN 47670 Individual and married couples arc limited to one homestead standard deduction.As the receipt of this deduction becomes
_ more beneficial,there is more incentive than ewer for homestead fraud.11one-stead fraud causes higher tai bills for a0:therefore.
® HEA 1344-2009 requires taapayers who teethe the homestead standard deduction to verify that they are eligible to recebe the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filinfr.This information will he kept confidential and can only be accessed by authorized county officials.The 1Xpannent 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 I env Address
Houchins, Brian K
10231 Ii Michigan
Oakland City IN 47660
8416
Brian K Houchins
10231E Michigan St State Parcel Number Legal Description
Oakland City IN 47660-7662
26-20-02-204-000.067-003 020-00067-00 MOORES ADD 13P7/16P7
I 111 f l l f f f l l 111111111111.111111111 l i i l l f t f f 111111111111111111 l
PART 2:TAXPAYER INFORMATION
Owner I ' First Middle Last
ng Address(number and sweet,city,state,and ZIP code) :j Some as property address
/02-31 Eas 1 l 'hct;yted 5-1fr e
Spouse First Middle Last
QQ
�IVt'l2 ' Rour✓C; wf
Mailing Address(Number and street,city,state,and ZIP code) ® Same as property address
/02-31 liarT oL.sa,. 571-9-et
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
Ibackk taxes and substantial financial penalties.
ner
Ow ignature Date
PART 4:ADDITIONAL INFORMATION