Homestead_Smithi
a° CLAIM FOR HOMESTEAD PROPERTY TAX M YEAR
CREDIT /STANDARD DEDUCTION
State Form 5473 (R2/1 -90) 1 44 92
INSTRUCTIONS: See reverse-side for filing instructions.
CERTIFICATION STATEMENT
I (We)
on the 1 st day of March , 19
'(We) occuabld 9 bLr prllnipal place of residence the following described real property for which a Homestead
Property Tax Credit is hereby claimed: ❑ 1 (We) owned Are buying under contract
El property a beneficial interest in the entity that is liable for the property taxes on the property and that owns the
property or is buying it under a contract.
CONTRACT RECORDED
If buyin on contract. F Simpl!J�wnef
Recorder's office where contract is recorded) Record Number Page
PROPERTY DESCRIPTION
, town,
V'G IX l
If any portion of the residential structure or the Ian not exceeding one (1) acre that immediately surrounds that struc-
ture 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
Count
Township
hereby certify the above statements are true. correct and
at r
complete.
ress (Street, number. city. state and ZIP code)
R o R
ASSESSOR USE ONLY TRUE TAX VALUE - ASSESSED VALUE HOMESTEAD VALUE NON - RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements
Otherland
Total land - line (1) plus line (2)
Residential improvements Dwelling
Garage
Other improvements
Total improvements - line (4) through line (6)
Total value - line (3) plus line (7)
(1)
1991 Pay 1992
Lesser of 112 Homestead
Valuation or $1.500
19— Pay 19—
Lesser of 1/2 Homestead
Valuation or $1,500
(2)
Signature of Auditor
(3)
-
(4)
- - --
-
(5)
(6)
(7)
(8)
1 hereby certify the above is true.
correct, and complete
Signature of Assesor
Date Signed
Verifying Action - Signature of Auditor
Date Signed
STANDARD DEDUCTION ALLOWANCE
1989 Pay 1 990
�Lesser of 112 Homestead
Valuation or $2,500
1990 Pay 1991
Lesser of 112 Homestead
Valuation or $2.000
1991 Pay 1992
Lesser of 112 Homestead
Valuation or $1.500
19— Pay 19—
Lesser of 1/2 Homestead
Valuation or $1,500
Signature of Auditor
Date Signed
•• STATE FORM!)'M,R`/WI nRrASumEB FORM 73-1A
APPROVED BY STATE IIMPOOf,rentsTS 9N PRE3PmED BY THE DEPARnner OF LOCAL GOVELVMF],T FINANCE MVI.IE_4.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead sandanl deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than e'er for homestead fraud.Homestead fraud causes higher tat bills for all;therefore.
• HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filing'.This information will he kept confidential and can only be accessed by authorized cowry officials.The Department of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION
Taxpayer Name Property Address
Smith, Jeffrey E/Karen K �I
RI Box 151 l-.)
Patoka IN 47666
2144
Smith,Jeffrey E/Karen K
4098 N 200E State Parcel Number Legal Description
PATOKA IN 47666-9213
IIlttllrtrlrlltFrllrrrl1rr1t1Fttt1Flr rrl ltFll tlr lrFlrEltltlttl 26-05-21-200-000.819-017 PTW NE 21-1-1055.26 AC D-12 C-1
A-
PART 2:TAXPAYER INFOR)MAT10!'
Owner I First Middle Last
JC"/E Y ____ EUO eNt Sin ) T hi
1g Address(n u m b e r mad s t ra ti,city.s t e m-a n d ZIP code) - -__-__ ._ _ __- _�Same ai prupenyaddresr' --
oygN 2001 PAFOK79 /P. If764,4'
Spouse First Middle Last
K4ReV K19Y 541 ITN
Mailing Address(Number and street,city,state,and ZIP code) ®Same as property address
9otYA/ 200E P4TO109 /j(/ 1- 7666
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 properly. 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 I Si tore Date
•