Homestead_Johnson (3)ea CLAIM FOR HOMESTEAD PROPERTY TAX
s� CREDIT /STANDARD DEDUCTION
State Form 5473 (R2 / 5 -92)
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INSTRUCTIONS: See reverse side for filing instructions.
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FORM -1 t YEAR
HC10 5 7 6
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CERTIFICATION STATEMENT .
31'1(We)owned ) _ te— le— �!►�o� certify that on the 1 st day of March, 19
) pied as our principal place of residence the following described real property for which a Homestead Property Tax Credit is hereby claimed:
❑ Are buying 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 under a contract.
CONTRACT RECORDED
It buying on contract, Fee Simple owner's name
Recorder's otlice where contract is recorded Record number Page
PROPERTY DESCRIPTION
County
Township . r
Taxing district (city, town, township)
Parcel number
6>0
Legal description Lq
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 propeny utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
Township
County
Township
I h -reby certify the above statements are true, correct and complete.
1
ign re t -
..odress (number and street, pry, state, ZIP code)
ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON - RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)'
Signature of Auditor
Date signed
Other land
(2)
Total land (line I plus line 2)
(3)
-
Residential improvements
Dwelling
(4)
-
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 pUs line 7)
(g)
1 hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
Wing action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19_Pay 19_
Lesser of 112 Homestead
Valuation or $2,000
5
Signature of Auditor
Date signed
• SIAEIDRSt a tR'!w4 TPG 9llIR FORM TS-IA
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Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N Main
PRINCETON IN 47670 IndividuaL.and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial.that is more incentive than net for homestead fraud.Homestead fraud causes higher tas bills for all:therefore.
• HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to teceise the
benefit and to provide additional identifvine information necessary to allow roomy goverment to better monitor homestead
filing..Ibis information will be kept confidential and can only be accessed by authorized county officials.The Depannienl of
Local Government Finance will use this information to create tc is that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION
Taxpayer Name Pr( t
Johnson, Phillip E/Linda
R Box 158 / •
�, /l Patoka IN 47666
755
Phillip E/Linda Johnson
R 1 Box 158 State Parcel Number Legal Description
Patoka IN 47666-9202
Itltrllltillttlllltlll ll llt tlr ll'Illtll tlr let rl'tl llrrl rr'I 26-05-22-100-000.368-017 0 1200368-00 PT 22-1-105.57 AC
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' PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
P//, 2z, ,6 ,67/9(e e S A/r/.So/t>
ng Addicss(number and irrect.city,stile,and 2tY code) -- — -'-_u.Same ua prepeny uddry- - — — -
�A/3 /I St �S- Pa, Ste!/ 276,6 G
Spouse // First Middle last
/6//L' dQ ,Lots o,jotA iSett/
Mailing Address(Number and sneer city,state,and ZIP code) ❑ Same as property address
/7147?/3 A/ oS2 6.5---- per, _i_7( cz76‘c
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 Signature Date
PART 4:ADDITIONAL INFORMA'T'ION
iv .