Homestead_Jones (5)f t<x
as CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (8215 -92) ?
tau
INSTRUCTIONS: See reverse side for filing instructions.
FORM YEAR
HC10
(� c v 1aJ0
_ Cho v Rw certify that o the ist day of March, 19
�e) occ' ied as our principal place of residen the following described real property for which a Homestead Prop6 C e i a�" herby claimed:
I (We) owned ❑ Are buying under contract AUDIi69*- -s
❑ 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 office where contract is reco rded Record number Page
' - PROPERTY DESCRIPTION
County
Township ,.
Taxing district (city, lgwn, township) _
Parcel number. _
Legal description
!!
AddresWer andostreet, city. state, ZIPOcntle)
.O ZS "& LGG A�
It 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.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
Township
County
Township
Sreby certify the above statements are true, correct and complete.
Signature o laimant
AddresWer andostreet, city. state, ZIPOcntle)
.O ZS "& LGG A�
�p
i,
ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON - RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Valuation or S2.000
Signature of Auditor
Other land
(2)
.c::?
Total land (line 1 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 plus line 7)
(6)
1 hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
v~ttying action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19 Pay 19 _
Lesser of 112 Homestead
S
Valuation or S2.000
Signature of Auditor
Date signed
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• SATE /%-0.1 TUFASAIR FORM 75-IA
AKMw EDDY StSTE 1nMRO(*MYYRllt!vs PLEYAIBW BY Till DEPAaneJrsF tURAEG(ACLA'Y.FXT MANCE IC 4-I.I-r-1.,
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 ester for homestead fraud.Homestead fraud causes higher tat bills for all:therefore.
HEA 1344-2009 requires mspayers who receive the homestead standard deduction to verify that they am eligible to receive the
benefit and to provide additional identifying information rtecrsln'to allow count'government to better monitor homestead
filings.This information will be kept confidential and can only be accessed by authorized county officials.The I)epan:nenl of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Jones, Timothy P/Pamela S
RI Box 154 Bb
Ha '47640
978
Timothy P/Pamela S Jones
R1 Box 154 Bb State Parcel Number Legal Description
Hazleton IN 47640-9325
26-05-57-123-002.961-017 009-02961-00 PT MD 123 1 10 1.00 AC
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PART 2:TAXPAYER INFORMATION
Owner I First •//^/(� /, / Middle A I Last
g Address(n u m b e r and sli4Rity:suiterand ZIP code) - — '—-- - ' --- — - -- R 6enw as properly addr- -- -- -- -- — -
67gs 4 /0/x .041 # zd cif 4'7 P
Spouse First Middle last
/I me i c? Skc e.-16,1de_s
Mailing Address(Number and sweet,city,state,and ZIP code) El Same as property address
l Q 7.9s /0 /1/j/o R-41 17�2cL71ofif , r y7G o
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.
(Tuner I Si crane - Date
•