Homestead_Allen (2) •
SLAVE FORM flHIR_/E.MI 11tFACIant FORM SIA
outman BY<I M.BO•RD OF MYYR.\ly ION PRF_YAmBmnY nut DEPARTMr:MT IftXM:xr rwRYMrxT FTA\CE ICsa.Iraf
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 n a 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 receive the
benefit and to provide additional identifying information necessary to allow county gvnemment to better monitor homestead
filing,-.This information will he kept conlidcmial and can only he accessed by authorized county officials.The Depannlent of
Local Govenunent Finance will use this information to create Owls that will help county officials eliminate homestead fraud.
PART ]: PROPERTY INFORMATION
Taxpayer Name Property Address
Allen, Jody R
lQ` R2 Box 103A
Fort Branch IN 47648
8502 . —---- - ... _ _ - _ — . _ —_ _
Jody R Allen
4674 S 800E State Parcel Number Lesal Description
FRANCISCO IN 47649-9124
IrinrrtitiiPttittiitittirittttt iittir�r�rr��l rr�r�rr�rr��t� 26-20-04-200-001.781-001 001-01781-00 PT NW NE 4395.00 AC
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PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
— peii,i / 1}v 4//e_ an
•
-41111Address(number andisueet,city,state,and ZIP code) — — —- -®-Same as property nddrs- — - —— — ' --
/11Q 71 5. 5/66 E . 1- anc;u , r . /17o'1Q
Spouse First Middle Last
J CQA 11 t- •
L1 ( QJD
Mailing Address(Number and street,city,slate,and ZIP code) ® Same as property address
(114 3 C() T • H1( Il3 CO 1.-n . L(7-tog.9
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 ciaiming additional homestead deductions •
unlawfully,he or she maable for back taxes and substantial financial penalties.
PART 4:ADDITIONAL INFORMATION
1�
S.e •'R
rd 9 CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
. ,�. State Form 5473 (R215 -92)
.eu
INSTRUCTIONS: See reverse side for filing instructions.
FORM YEAR
HC10
.._ ... _ • tsvc
I CCU ) + certify. that on the Flay @ @a, rl,8,%
'ccupie s our pr' pal place of residence the followingldescribed real property for which a Homestead Propert Tax Credit is here /by claimed,
,� . ,i owned Are buying under contract , � f /y /7 / /(n/
❑ Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the propttrtybcls buying under'a.corlilactl
CONTRACT RECORDED
It buying on contract, Fee Simple owner's name - -
Recorders office where contract is recorded Record number Page
'-
County
PROPERTY DESCRIPTION
County' .
Township
-
Taxing district (city, toyfri, ffiwnship) - -
Ad ss (number and street, racy, state. ZIP code)
7 '7
Otherland
Parce number
- D17 � / -�
Legal descriptio
f %l
(7 ,
V -3 -7
It any ponion 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.
Residential improvements
Dwelling
(4)
Garage
(5)
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
Township
County
Township
N. certify the above statements are true, correct and complete.
=
Ad ss (number and street, racy, state. ZIP code)
7 '7
ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON- RESIDENTIAL
- VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Otherland
(2)
Total land (line I plus line 2)
(3)
Residential improvements
Dwelling
(4)
Garage
(5)
-
Other improvements -
(6)
_
Total improvements (line 4 through line b)
(7)
i
Total value (line 3 plus line 7)
(6)
I hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
Verifying action - Signature of Auditor
Date signed
19 —Pay 19_
Lesser of 112 Homestead
Valuation or $2,000
S