Homestead_Mason0 CLAIM FOR HOMESTEAD PROPERTY TAX �Q �j_ FORM YEAR
CREDIT /STANDARD DEDUCTION ,� H010
State Form 5473 (R614 -03)
Prescribed by the Department of Local Government Finance 11 }
INSTRUCTIONS: See reverse side for filing instructions. SE I 'G . LOOY
ERTIF.ICATION STATEMENTi%r . { •n•X"u`r
(We 1'LG Certify that on the 1st day of March, 20_
"'cry,
I ) occupied as our principal place of residence the following described real property for which a Homestead Property Tax Credit is hereby claimed:
I (We) owned ❑ 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.
a, CONTRACT: RECORDED
' W. iscva -`a,'.+``.:a'i$*Ya:°."r.�.: -:
If buying on contract, Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
P,ROP,ERTY:DESCRIPTI K',�'fi��:�"- rte.§ '.'?ip`�i'���#�'�#".��g'�r�3'_.
County
Township
I hereby certify the above statements are true, correct and complete.
Twing distill , town,11%Vns
)
a�VALUEt
.i,
aAT ;700 /e OFrtTTV
VALUE
±.T,..K�?
,?
rF. #rS«`«z^VALU r
Land not exceeding 1 (one) acre immediately
Parcel nu r
Le caption
ro
the property in question:
a v -.
❑ Real property ❑ Mobile Homo (I.C. 6-1.1 -7)
(2 )
If any portion of the residential structure or the Land not exce6diXg one (1) a th mediately surrounds that structure is used to produce income. describe the use and portion
the
of property util zed to produce income.
a� -o� -06 - goo -000.
38fYo.
017
U��� �lr�"�- PROP.ERTYOWNED:BX CLAIMANT IN', OTYiER`COUtJTiES:�`..�`.''�.,.-
County Township
County Township
I hereby certify the above statements are true, correct and complete.
Signature clef nt
' +ress (number and street, city, state, ZIP code)
2 '`1TRUE
5"•�'r'.
TAXp
�'
ASSESSEDYALUE
e
_ HOMESTEAD'
NON- RESIDENTWL n
L'>r•-
a�VALUEt
.i,
aAT ;700 /e OFrtTTV
VALUE
±.T,..K�?
,?
rF. #rS«`«z^VALU r
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
land
(2 )
—� JA
INOther
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
Residential impmvements or Annually
Assessed Mobile I Manufactured Home
Garage
(5)
_
> • * °•[, s
Utz
Other improvements
(6)
"y' eX• --T
Trial improvements (line 4 through line 6)
(7)
Trial value (line 3 pits line 7)
(6)
I hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Dale signed
i',cs?•+ ' -;u k-i, .jv , ., j - s"=.STANDARD:DEDUCTION ALLOWANCE .-S F'' s
20 _ Pay 20
Lesser of 112 Homestead
$
Valuation or 535.000
Signature of Auditor Date signed
STATE MANI•,Y•IRfl s..B1 ntrAsuanA FORM:S-tA
.Aflfltf BY RITE WARnnrMYYRc1'.ivy FLLAN&m BY TM DEPARTS-That LOCAL rtvxxtt.Y.EAT FIANCE IC.t.I-::$.1 •
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Indiriduab and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than e'er for homestead fraud homestead fraud causes higher tax bills for all:therefore.
• HEA 1344--?009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to seethe the
benefit and to provide additional identifying information necessary to allow county gmrmttlent to better monitor homestead
filintts.This information will he kept coatdemial and can only he accessed by authorized county officials.The Dcpannent of
Local Government Finance"ill use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY LNFORIILATION
Taxpayer Name Property Address
Mason, Shawn G/Andrea C
a cone on c
- R`z lyNIG Ci
'1)a04ua&IN47o40
1011 Al
Shawn GMason 53y 1 L /SO
H.}.g .Ar. State Parcel Number Legal Description
HAZLETON IN 47640-9341 1 I •
ltlnllutltllulilnlllntltlnnllnlnlnrilitin ln tlllntll 26-06-06-100-000.605-017 009-00605-00 PT NW 6-1-938.40 AC
S
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
SlIAWW . GREGo&y MAcoN
tg Address(nitrhber mid its eL city,sttate:and LIP code) -- — -- - —-- f-Same m property a.drea — -- — - — —-
P L(-� a -750 N HAzt�-Le , IN 47 b LF o
Spouse First Middle Last
/ANDREA ChiRL 1 P6DN
Mailing Address(Number and street,city,slate,and ZIP code) ❑ Same as property address
$cG A5 A3o'IE
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 maybe liablle for back taxes and substantial financial penalties.
•. CT : 1 one Date
PART 4:ADDITIONAL INFORMATION
lo1e4 n adidIvtsc X01-19 e 15D N HAz eTbr IN 47/0 LI0
•