Homestead_TichenorCLAIM FOR HOMESTEAD PROPERTY TAX
i: CREDIT /STANDARD DEDUCTION
State Form 5473 (R2 / 5 -92)
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INSTRUCTIONS: See reverse side for filing instructions.
FORM YEAR
HC10
:CERTIFICATION STATEMENT.°
I (We) N a- e'1 a7 certify that on the 1st day of March, 19_
1 (We) occupied as our principal place of residence the following described real property for which a Homestead Property Tax Credit is hereby claimed:
-l(We)owned ❑ Are buying under contract ''j���jj{{���
_ Have a beneficial interest in the entity that is liable for the property taxes on the property and thas�e�ropy'S� i if under a contract.
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CONTRACT RECORDED_ •. _ - -r°
If buying on contract, Fee Simple owner's name
Recorders office where contract is recorded G(g50N 0
con, t s r P)
Page
-
PROPERTY DESCRIPTION
•,
Coun
�o,✓
Township
scy.
Taxin�i ,rid (city
con, t s r P)
Parcel number
0/3._ C)
Legal description
Otherland
(2)fD'
It 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
I hereby certify the above statements are true, correct and complete.
Sig ant
T
ress(number and street, ci .state, [P code)
lO
r
ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON- RESIDENTIAL
VALUE -
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
u on or $2,000
-
-
Otherland
(2)fD'
r a -
Total land (line 1 plus line 2)
(3)
Residential improvements
Dwelling
(4)
-
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(g)
I hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
verifying action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE'
19_Pay 19_
es er of 112 Homestead
$
u on or $2,000
Signature of Auditor Date signed
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• APIMwEO DI'St OF BOARD OFAmtIsT S.Zoug PRCYRIBm BY TM;DEPARTMINt If LOCAL(5WtRNMEAT FINANCEMH.I-H4.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and manned couple are limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than e'er for homestead fraud.Homestead fraud causes higher tat bills for all:therefore.
III HEA 1344-2709 requires tatpayem who rereise the homestead standard deduction to.erify that they are eligible to recebe the
benefit and to provide additional identifying information necessary to allow county goemtnent to better monitor homestead
filings.This information will he LEpt confidential and can only be accessed by authori,ed county officials.The Ikpannsent 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
_ Tichenor, Jonna
P O Box 353
Haubstadt IN 47639
8181 OIL
Jonna Tichenor
P O Box 353 State Parcel Number Legal Description
Haubstadt IN 47639-0353
26-19-31-301-000A55-009 013-00455-00 ORIGINAL PLAN 53 PT/54
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PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
• SO �/�v4 oft / 6./v en 1. e ivo i2
ion g Address(number and street,city.state.and ZIP code) _ -_ nme as propers tiddtvss. -__.— - __ — _— - —
/90A0X ? 3i 71(4qgs /4-P // T/v v9i3 /
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) I1.Siine as property address
Social Security Number(last 5 digits) Dritet's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
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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.
Owner I Signs e P t t h�t e y/ a/4
PART 4:ADDITIONAL INFORMATION
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