Homestead_SollmanCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
,J State Form 5473 (R2 15-92)
reu
INSTRUCTIONS: See reverse side for filing instructions.
FORM YEAR
HC70
I (we) -Z - certify that on tsi day of March, 19
ke) occupied as our principal place o residence the tollo g described real pro y for whch a Homestead Proper - t ere)) cl, aimed:
s
❑Are buying under contract AUDITOR
❑ 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 -
If buying on contract, Fee Simple owner's name
Recorder's office where Contract is recorded Record number Page
-
PROPERTY DESCRIPTION
County
Township
_
Taxing district (dry, town, township)
(1)
Parcel number
Legal description
Total land (line I plus line 2)
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.
ASSESSOR USE ONLY
TRUE TAX
.VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON - RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Otherland
(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 pbs line 7)
(6)
1 hereby certify the above is true. correct, and
complete.
Signature of Assessor
Date signed
® "lying action -Signature of Auditor
'L
Date signed
L
19 _Pay 19_
Lesser of 1/2 Homestead
Valuation or $2,000
3
ALLOWANCE
of Auditor — . I Date
STATE De/stn1 MEASURER FORM:S-IA
AFFRM'ED By SIDE 1vWDnrll[s(:TC 9M PRFSWBEDDT PIE DEPARTWVH4 LOCAL r R_NsrxT rn:ACCE k t.I.r4I
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 ter for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
HEA 1344-7009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
benefit and to provide additional idennfvme infomrmwn necessary to allow county government to better monitor homestead
filings.This information will 1w kept con:deniial and can only he accessed by authorived rnumv officials_The Ikpanment 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
Sollman, Darryl G/Angela R —3p..e 'o'-`_
R I Dux 169 C `�%
Hazleton IN 47640
718
Darryl G/Angela R Sollm n
R1 DOA-1-69 C- c_
Hazleton IN 47640-9336 State Parcel Number Leal Description
26-05-01-400-002.786-017 009-02786-00 PT LOT 6 FR 1 1 10 13.33
11111111111111111111111111111 n I I I I I I I I t I t I u It II t
AC
• PART 2:TAXPAYER INFORMATION
Owner 1 First Middle Last
ORRRY/ So M � ,✓
—_'/ ,g Address(number and straw,city,sate,and ZiP code) — __ _ Same Ds property address. — - — __...
/ /N, 5,R-_ 4._5- H4ZLFro,, TJ. X76fb
_
Spouse First Middle Last
/466-1s< gore SO Z-1-474
Mailing Address(Number and street,city,state,and ZIP code) Same as property address
4ws 4/, szirc R.D &S hi/tzar 7ov ,r4" L176y0
Social Security Number(last 5 digits) Driver's License/State ID Number (last S digits) Other(please specify in Part 4 below)
(o- S373 6_ Ci/tea3
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 elieible 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 1 Signal Date
PART 4: ADDITIONAL INFORMATION
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