Homestead_Hill (2)F`
CLAIM FOR HOMESTEAD PROPERTY TAXN� FORM YEAR
CREDIT /STANDARD DEDUCTION Hcto
State Form 5473 (R614-03)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing insinrctions.
CT 1 2004
/ lI,LL�22X -Y T Lf'.e_' cer-6'fy that on the tsl day of March, 20_
e) occupied as our principal place of residence the following described real property for which a Ho estead Property Tax Credit is hereby claimed:
I (We) owned ❑ Are buying under contract /C�/ `✓f {( Jl
Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns tfieproperty or is buying under a contrail.
r-CONTRACT,RECORDED
If buying on contract, Fee Simple owners name
Recorders offico where contract is recorded Record number Page
c< -t'arg YASSESSOR USE ONLY -� '=�¢'5
PR' OPERT ,Y,DESCRIPTION+1t_,.b_�.'_�:'s,
County
Twmship
Taring district (city, town, township
Parcel numberL
al 'ption
Is the property in estion:
l7 pQ
VALUE'S
Real property ❑ Ivabdo Home ( /.C. 6-1.1 -7) .
If any portion of the residential 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.
c< -t'arg YASSESSOR USE ONLY -� '=�¢'5
p{1"'_ Ju
TRUETAX
County Trxvnship
County Township
1 hereby certify the above statements are We, correct and complete.
Siggatur of claimant
X
'ress ( bar ands illy, state, ZlP
�d
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iv�.. -,.
c< -t'arg YASSESSOR USE ONLY -� '=�¢'5
p{1"'_ Ju
TRUETAX
- -'o"
ASSESSED VALUE
HOtdESTEAD'f
"'iVAL'UE
-..
NON-4 ERiQ W:IAL _ h
°'- `'-
_ YALUE`'Y'SATk700Ye'OFTSV
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VALUE'S
Land not exceeding 1 (one) acre immediately
11)>;r^k
surrounding residential improvements.
Other land
(2)
- : W-3,81,
F.:- 1
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
t���ar�� � ���
I04'
as -
Residential improvements or Annually
Assessed Mobile I Manufactured Home
Garage
(5)
L
Other improvements
(6)
- sue:...:.
�? �i
Total improvements (line 4 through line 6)
(7)
Trial value (line 3 plus line 7)
(6)
hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
STANDARD:DEDUCTION ALLOWANCE
20 _ Pay 20
Lesser of 112 Homestead
valuation or 835.000
5
Signature of Auditor Date signed
STAVE FORM•)W In1SW l TREASURER FORM 7S:A
APPROVED fYSTUE BMW OWMn,e-n.a•w PRrS(WDFD BY TlIr DEPARINRR(f LOCAL r.ovaNS:rf'r FINANCE 1c11.1.1-21-1.1
Gibson County Auditor
101 N Main u 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
s more beneficial,there is more incentive than ester for homestead fraud.I lomesteol fraud causes higher tax bills for all:therefore.
tea--. HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to recei a the
benefit and to provide additional whe identifying confid tial and can necessary accessed to allow county government county officials vials monitor
De homestead
of
filirq�w.'Ihis information will he kepi confidemial and can only be accesuA M1Y authorized counh'NTicial.-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
APR 1 3 *LU1U Taxpayer Name Property'Address
777040 /� Hill, Russell LEric C
GIBSON COUNTY AUDITOR Francisco IN 47649
911 1 R
Russell L Hill
R1 Box 63A State Parcel Number Legal Description
FRANCISCO IN 47649-9225
III erI n III I I uuI I nI r I r I r I t I I fir fir I I 26-05-47-125-000.297-017 009-00297-00 PT LOC 125 13 1 10 1.42 AC
err err rnrr C-1
PART 2:TAXPAYER INFORMATION
Owner I First �� ; 1 Middle �T�i Last
rip if-id 3eLL N e
g Address(number and street,city,sate,and ZIP code) '— — Sawa m property Bddr.<:---- -- -- —
4'7o s N sco E ,c@94cisca , AJ Y9 6V?
+
Spouse First Middle Last
Mailing Address(Number and street,ciy,stale,and ZIP code) ❑ Same as properly address
c_529ey1'e
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 Si re Date
PART 4:ADDITIONAL INFORMATION
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