Homestead_StevensCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (R7 I fimM
Prasaited by the Department of Local Governinerd Finance
INSTRUCTIONS., See reverse side for filing insirrurcUons.
I (We) vdjt! e, certify that an the I st - t8
I (We) ocopied as our principal place of residence the following described real property for which a Homestead Properly N 0,,
❑
I (We) owned ❑ Am buying undwoontract OR
a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is Wog under a contract
if buyvV on contract, Fee SwrqAe owner's name
Recorder's ofte where contract is recorded Recud number Page
-0FfdPERTYDESCMft0N
County
Township
County
I _ 'Township
-. I
kkl N0N4tESlDFNTU
Panel rKarber
al description D -f fl,? JJ
/Z' J- I
Is the property in question:
Ug*
.1 3
Reel property ❑ M.W. Home (I.C. 61.1-7)
tt =;;uftb==—Cb— W the Land not exceeding one (1) acre
that immedatety surrounds that structure is used to produce income, describe the use and portion
suffoundkV residential improvements.
- aD -& - qO Y - OOD, 3 J, 7 - o03
L- A
�N
Rt;
ii ?� ASSESSOR Nl Or-4'. ';�� ✓�i�'
County
Township
I
County
I _ 'Township
-. I
kkl N0N4tESlDFNTU
I hereby certify the above statements are true, correct and complete.
$
Arld� unbar 8; sb;§ dly; stets, ZIP code)
L- A
�N
Rt;
ii ?� ASSESSOR Nl Or-4'. ';�� ✓�i�'
iii7
—
ASSESSED E
.:,!-IOMESTEAW,�
-. I
kkl N0N4tESlDFNTU
Valuation or 535.000
$
Signature of Auditor
?WZVA UE
Ug*
Land not exceeding 1 (one) acre immediately
suffoundkV residential improvements.
'N
Other land
(2)
Total land (line 1 plus fine 2)
(3)
Dwelling
(4)
Residential improvements or Annually
Assessed Mobile I Marsdactiured Home
Garage
rag
(5)
Other improvements
(6)
x?i %I'YX./'+Zrfi
Tdal improvements (Ene 4 through Erie 6)
(T)
Tdal value (lore 3 phs ffria 7)
(8)
1 hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
Veffying acbm - Signature of Auditor
Date signed
s-rAN D ARD D ED u cm o N W: COWAN r-E -T&'4 <%' 6-# 'N' I
%1*AW' -V 9. W
20_Pay2D_
Lesser of 12 Homestead
Valuation or 535.000
$
Signature of Auditor
Date signed
•
STATE FORM!)w+IR'/•PI 1RFl3ULEA FORM 1.-IA
APrROVEn BY cr1TL BDARD(F AM'Plx.?ON PRESCRIBED BY for DEPARTMENT IF LIX'ALr(w'c RYNrfl FINANCE K'/.1.1 4:1.1
• Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples arc limited to or homestead standard deduction.As the receipt of this dedunion becomes
more beneficial.there is more incentive than ever for homes-read fraud-Homestead fraud causes higher tax bills for all:therefore.
HEA 1341-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to reeeise the
benefit and to provide additional identifying information necesary to allow county government to better monitor homestead
filings.This information will be kept confidential and can only be accessed by authorized county officials.The Department of
Local Government Finance will sex this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Stevens, John E •
PO Box 3 I I
_-- - - _ - --- Somerville IN 47633
3228 ——-- - — -•
John E Stevens
10369E Main St State Parcel Number Legal Description
OAKLAND CITY IN 47660-7702
I I III I I I I I I I III
t o tit t tit n tit tit tit 26-20-02-404-000.327-003 PT SE SE 2 3 9.304 AC OLD
ton
PLAN I6PT
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 First Middle Last
Thh E Ue(e f-ieven5
4111mg Address(number and street.city,state,and ZIP code) ❑ Same as property address
103(aq L main S . (4)av, rx1 (14 , Di. CI I(OCoO
•
Spouse First Middle Last
Mailing Address(Number and street,city,stale,and ZIP code) I I Same as property address
c� �c nel F. Y))Ct ; n bk C304 VJCv- -I 0 ('-I- / Tit 7(d ()
Other(please Specify in Pan 4 below)
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•. . substantial financial penalties.
Owner I Signature / � Date
PART 4:ADDITIONAL INFORMATION