Homestead_Weaver flit FOAMS 5 IR'/'V•I TREASURER FORM iRIA
.LPrR/n'ED BY STATE WARM*MCI t Th.9v PRXXAmRI BY PIE DEPARTMENT. Of LOCAL rAnER`MEM11 FINANCE IC 1-1.1-224.1
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 eser for homestead fraud.homestead fraud causes higher tan bills for all:therefore.
® HEA 1344-2O09 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to recene the
benefit and to provide additional identifying infonnatwn necessary to allow county government to better monitor homestead
filings.This information will be kepi confidential and rim 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.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Weaver, James Lee Jr/Lisa L
RI Box 128 A
Ilaubstadt IN 47639
3146
James L Weaver Jr.
302 S 5th Ave State Parcel Number Legal Description
HAUBSTADT IN 47639-8222
IIl ��tlr�1��11rr��r�r�rl�rl�n n u nn
l�t� �t� �l��� l�l�l�l�tl 26-19-31-400-000.410-009 BRIARWOOD 2 D-9
r1
This form MUST be returned to County Auditor's office.
Please do NOT send this form back with your tax payment to the county treasurer.
PART 2:TAXPAYER INFORMATION
Owner I 1./" First Middle pp ,, Last
es L �J ecY-v el
Address(number and street,city,state,and ZIP code) 111 Same as property address
\oa �., !� sue+ —N L--76E7
Spouse First Middle Last
Mailing Address(Number and street,city,state,and Z code) ❑ Same as property address
Soa S. s-' kt
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 Signature Date '
$
•
PART 4:ADDITIONAL INFORMATION
S
CLAIM FOR HOMESTEAD PROPERTY TAX FORM J YEAR
CREDIT /STANDARD DEDUCTION 8�D
State Fomt 5473 (R6 /4-03)
Prescribed by the Department of Local Government Finance _
INSTRUCTIONS: See reverse side for riling instructions.
I (We) d certify that on the fanday�o MveWr, 20_
I (We) o pied as our principal place of residence the following described real property for which a Homestead Prgpedy3Tak -(j i 'Jjs he, ned:
) 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.
If buying on contract, Fee Simple owners name
Recorder's office where contract is recorded Record number Page
€u' ; Y.F fi.. ". P,ROP.ERTY>DESCRIP,TION�%
T.:>v!.t. ^:.S'�s`a
County
Township '
Taxing isInct 'ty, to n, township)
Parcel number
Q
I description We _ Is the pro rty in question:
property ❑ Mobile Homo (I.C. 61.1 -7)
If any portion of the residential structure or the land not exceedin acre that immediately surrounds that structure is used to produce income, describe the use and portion
of the property utilized to produce income.
M''` ��,€, a_- .t�,�t"`�t`PROP,ERTY,OWNEbBY CLAIMANT :IIJ.OTHER`000NTIES'',>.'+ .}''?` }'L$s „'. 4._'-y>f?'';
County
Township
County Township
I hereby certify the above statements are true, correct and complete.
Sign a of a
Address (number and street city, state, ZIP code)
L '�iai 4 t. <-+ r a
'ASSESSOR USE ONLY �
°z TRUETAX �ti
VALUEr'f� f”
ASSESSEDVALUE
""AT _100 %OF�TTV
_
eY HOMESTEAD~'
�T*-.V_ALUE�,
1
"� �'J"NON- ,RESIDENTIAL
'�`t 4 VALUE^ . *, n Ay-
Land not exceeding 1 (one) acre immediately
sufrounding residential improvements.
1
£/ ", 4f� "t �+I 41,
Otherland
(2)
r .asr.• c"TS -'
r'S 3IhK
Trial land (line 1 plus line 2)
(3)
IResidential
Dwelling
(4)
s2��,ya,'I�-'. �
° -
improvements or Annually
^ed- �a'�*��`` ''�
Assessed Mobile /Manufactured Home
Garage
(5).�
Other improvements
(6)
_.• '`W
Trial improvements (line 4 through line 6)
(7)
Trial value (line 3 plus line 7)
(6)
I hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature offwditor
Date signed
..r- STANDARD '.DEDUCTION "ALLOWANCE ?T.6
20_Pay 20_
Lesser of 112 Homestead
Valuation or 535.000 5
Signature of Auditor Date signed