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Homestead_Folsom (3)e.� ^l",\ CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT/STANDARD DEDUCTION A State Form 5473 (R2 / 592) INSTRUCTIONS: See reverse side for filing instructions. FORM YEAR HC10 IlkV V I 1 %d" PROPERTY DESCRIPTION CERTIF TIO STATEMENT Taxing distric (ci . !or n. • wnshid r .0 h /I /0 ^ O Legal description 1 twe) certify that on the 1 st day of March. 19 16) occupied as our principal place of residence I ollo I g descrt ed real property for which a Homestead Property Tax Credit is hereby claimed: h (We) owned ❑ Are buying under contr NON - RESIDENTIAL VALUE ❑ 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. Other land (2) CONTRACT RECORDED It buying on contract. Fee Simple owner's name NOT � tlD ®tl � C lJJ}E J Recorder's office where contract is recorded (3) Recor mber - Page IlkV V I 1 %d" PROPERTY DESCRIPTION County Township Taxing distric (ci . !or n. • wnshid r .0 h /I /0 ^ O Legal description If any portion of the rresidential 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 Township ®eby certify the above statements are true. correct and complete. i Signature i nt Address (number and street. city. state. ZIP code) ASSESSOR USE ONLY - TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON - RESIDENTIAL VALUE Land not exceeding I (one) acre immediately 111) surrounding residential improvements. Other land (2) Total land (line I plus line ) (3) Residential improvements Dwelling (4) Garage (5) Other improvements (6) Total improvements (line 4 through line 6) I (7) Total value (line 3 plis line/) (g) 1 hereby certify the above is true. correct. and complete. Signature of Assessor (Date signed �ying action Signature of Auditor Date signed STANDARD DEDUCTION ALLOWANCE 19_Pay 19_ Lesser of 112 Homestead $ Valuation or S2.000 Signature of Auditor Date signed • � AVE DM TPfAAEER MBAI TS-IA APrMm VEn nYMAEE IXAR Dnr ACC(*.N1(.]•+ PRrBYIUBm BY Mt DEPARTMENT OF LOCAL fMZLVNIXirO:AVCEr 6-E1--11 le Gibson County Auditor 101 N Main IMPORTANT NOTICE TO HOMESTEAD• PROPERTI' OWNERS PRINCETON IN 47670 Individuals and Married couples are limited to air homestead uandard deduction.As the receipt of this deduction becomes more beneficial.there is more incentive than ncr for homestead fraud.homestead fraud causes higher tax bills for all:therefore. HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verily that they are eligible to reoeue the benefit and to provide additional identifying information necessary to allow county government to better monitor homestead filings.ibis information will he kept conlideinial and run only be accessed by authorized county oflici'als.The Depanntent of Local Government Finance oil'use this information to create tools that will help county officials eliminate homestead fraud. PART I: PROPERTY INFORMATION -- _. - - -- Taxpayer Name - _ _Property Address - Folsom, Robin L/ Billy J R I Box 74 Francisco IN 47649 1094 Robin L/Billy J Folsom 7127 E 450 N State Parcel Number Legal Description Fr.anciscn.IN.47fido_o74l ,�,_„,,,, �� 'an nrxn von �- - 0.17---•-‘10-4)0.784-00 PT NW NE 2O-1-9 121,7. A7�— • PART 2:TAXPAYER 1NFORMATIONN Owner I First Middle Last it e' _ ---- -- - Smnc propertj-addr.ss - a .r ''so /v Eancisc T, S.y9cy% � Spouse First Middle Last AA/'4 yn gtsa Mailing Address(Number and street,city,state.and ZIP code) Same as property address 7/e-,Z ,/ A- 4<ro /� �Q n,c e o Z/7 `r/74 clY 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 ft