Homestead_Bullockei 3° CLAIM FOR HOMESTEAD PROPERT FORM . YEAR
CREDIT /STANDARD DEDUCTION HC10 R
). State Form 5473 (R2/1 -90) •
INSTRUCTIONS: See reverse side for filing instructions.
FILED.
CERTIFICATION STATEMENT
(We) g ��c `J� certify that on the 1st day of March , 19 91
I (We) occupied as our principal place of residence the ff wing described re�r0flAI D AY19domestead
Property Tax Credit is hereby claimed: C/J I (We) owned ❑. "AIrJeUbf fuying 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 it under a contract-
CONTRACT RECORDED
If buying on contract, Fee Simple Owner's Name
Recorder's office where contract is recorded Record Number Page
PROPERTY DESCRIPTION
County Township Ta ip)
Parcel Number Le ID ription
66 —Dd - ate,
If any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that struc-
ture is used to produce income describe the use and portion of the property utilized to produce income. 6 a 3 0
8749 - _� ,J /ayo
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
certify the above statements are true. correct and
state
ASSESSOR USE ONLY TRUE TAX VALUE _ ASSESSED VALUE HOMESTEAD VALUE NON - RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements
Otherland
Total land - line (1) plus line (2)
Residential improvements - Dwelling
Garage
Other improvements
Total improvements - line (4) through line (6)
Total value - line (3) plus line (7)
(1)
1991 Pay 1992
Lesser of 1/2 Homestead
Valuation or $1,500
19— Pay 19—
Lesser of 112 Homestead
Valuation or $1,500
(2)
Signature of Auditor ,10
(3)
(4)
--
- -
(5)
(6)
(7)
(8)
1 hereby certify the above is true,
correct, and complete
Signature of Assesor
Date Signed
Verifying Action - Signature of Auditor
Date Signed
STANDARD DEDUCTION ALLOWANCE
1989 Pay 1990
Lesser of 1/2 Homestead
Valuation or $2,500
1990 Pay 1991
Lesser of 1/2 Homestead
Valuation or $2,000
1991 Pay 1992
Lesser of 1/2 Homestead
Valuation or $1,500
19— Pay 19—
Lesser of 112 Homestead
Valuation or $1,500
Signature of Auditor ,10
Date Signed
SLATE I ORM 53W 11L'I■■■ TREASUIrn.r&M TI-IA
APPROVED BY SInn aORRDOF ACYYtINT S_ION PP.FIWBED BY THE DEPARTMENT or LOCAL COVERNMWT F PALACE MVt3-L`3.1
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
HT;beneficial,there is mare inerntive dun ter for homestead fraud.Homestead fraud causes higher Tax bills for all:therefore.
• H!A 1344-7009 requim taxpayers who receive the horn estead standard deduction m veriti'that they are eligible to recei a the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will be Leg tontideruial and on only be accessed by authorized county officials.The Depanment of
Local Government Finance will sew this information to create tools that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION
Taxpayer Name Property Address
Bullock, Arlin C/Shirlan Kay
6603 N SR 65
Hazleton IN 47640
717
Arlin C/Shirlan Kay Bullock
6603 N SR 65 State Parcel Number Legal Description
Hazleton IN 47640
26-05-01-400-002.559-017 009-02559-00 PT S 1 1 10 9.92 AC
C-1
PART 2: TAXPAYER INFORMATION
Owner I /1/et i ,J First C I Middle _Ea/ a G Last
.5454a;394) le- RISI*R4
•Tg Address(number and street,city,grate,end ZIP code)- - - "- -" - i it Same as property address - - -- - - —- -
G 6 6 3 /t/e Sf;/fe led H LI I/ifzZnciti /ti V?to yo
Spouse First Middle Last
Mailing Address(Number and street,city,stale,and ZIP code) ®Same as prepeny address
66 03 ii/. S1/3to 1P--671?-,46 6'S h'zCC-'To/(J /4/ S'?cflo
,
PART 3:CERTIFICATION
Each undersibmed 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 ' aturc Date
PART 4:ADDITIONAL INFORMATION
ID