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Homestead_Johnson (3)ea CLAIM FOR HOMESTEAD PROPERTY TAX s� CREDIT /STANDARD DEDUCTION State Form 5473 (R2 / 5 -92) reu INSTRUCTIONS: See reverse side for filing instructions. Im FORM -1 t YEAR HC10 5 7 6 a Q - '7v 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 .ArrRrWtn PI'�intE Pnl0.Dor HyiA'�TTS.FAY PtIS IBDBYIIE DEPAUN.047IF LORAL CIK'ct'MrTT FIANCE IC€1.1-E4.1 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 tt l ' 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 .