Homestead_Wells SIATE IOt'"53.,n11L'I1w1 TYEASIIPIR FORM TSIA
APPROVED BY MITE BOARD 01: Umt9+ rtF_IIWILD BY TIE DEPARTMENT If LOCAL O1ntLNMIM FINANCE MH4"-LI
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.Ilomestead fraud causes higher tax bills for all:therefore.
• HEA 1344--21109 requires taxpayers who receive the homestead standard deduction to verify that they am eligible to creche the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
EI x flings.This information will he Leg confidential and can only be accessed by authorized county officials.The Depanment of
j{F9It✓, L 3 Local Government Finance will use this infoation to create tools that will help county officials eliminate homestead fraud.
, PORT 1:rm PROPERTY INFORMATIOhomestead
Taxpayer Name Property Address
APR 2 6 ZULU Wells, Tonya J _
jj 201 N Ijafe
`der~/�, Haubsmdt IN 47639a\L
817tIBSON COUNTY AUDITOR •
Tonya J Wells
201 N Main State Parcel Number Legal Description
HAUBSTADT IN 47639-8138
lllllll llllllllllllllll llllllllllllllllllllll ill 11111,11
26-19-31-301-000.386-009 013-00386-00 ORIGINAL 11/12PT
l)(
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
--ro'nya S�a� _ WcIIs
�g Address(number and street.city,state,and ZIP code) E-Snme ns property address - - - -
2o 1 • fa:, kili-ti hs-1-a01-f -- )--1 - L/ -ri!a 39
Spouse First Middle Last
An on S0._vv`es ,�,�/ r IIS
Mailing Address(Number d street,city.state,and ZIP code) (ame as property address
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
ill
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
♦ State Form 5473 (R6/403)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for tiling instnictio,,
Fftj 6M]
MAR 2 12005
I (We) loz_'4A C4, re 't
AD#&Ach, 20_
1 (We) occupied as ou ncipal 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
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.
CONTRACT RECORDED
If buying on contract. Fee Simple owners name
Recorder's office where contract is recorded Record number Page
PROPER7 -OWNED BY CLAIMANT IN OTHERtOUNTIES
:PROPERTY DESCRIPTIONS
County
Toomship
_62
Township
T g I cl (iuty , I �thip) 9
ignaturq of claimant
ttal escription
& �Wa
AL, 2 � I
Is the dropt�nyVi question
W Real property ❑ Mobile Homo (I.C. 6-1.1-7)
If any portion of the residential structure or the land not ceeding one (1) act....,. t imme iatety surrounds shat Anichire is used to produce income• describe the use and portion
of the property utilized to produce income.
PROPER7 -OWNED BY CLAIMANT IN OTHERtOUNTIES
County
Toxnship
County
Township
I hereby certify the above statements are true, correct and complete.
ignaturq of claimant
ss rand street, city, state, ZIP code) L/
1rid
"��4 LOQ39
�j
ASSESSOR USE ONLY
TRUE TAX
ASSESSEDVALUE
-TV
-�'HOMESTEA
'vAwrz-;
NON-RESIDlihTI4LL
-.VALUE
AT oF..T
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 or Annually
Assessed Mobile I Manufactured Home
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Trial value (fine 3 plus line 7)
(8)
I hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
a --STANDARD. DEDUCTION ALLOWANCE-.
20 Pay 20
Lesser of 112 Homestead
valuation or $35.000 1
of Auditor I Date signed