Homestead_Barr a
STATE FORM 53,4.1r1.-0.1 IAIASUEEA FORM 75-IA
.AITRRT'ED BY ST ME BniRD Of-N??tl\TS.gx Fr(Ygtan)BY TIE DEPARTMENT();LOCAL GOVERNMENT raPA\CE IC6-I.I14.1
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 eser for homestead fraud.I lorlleslaad fraud causes higher tar bills for all:therefore.
.• HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verity that they are eligible to tetchy the
benefit anti to provide additional identifying information necessary to allow county goverment to better monitor homestead
filing.This inf rmation will he kept confidential and can only be accessed by authorised comity officials.The Ds-Taunton 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
Barr, Michael/Connie
ntn.,. IItl
Oakland City IN 47660
8598
Michael Barr
6584 S 1025E State Parcel Number Legal Description
OAKLAND CITY IN 47660-7717
26-20-11-400-001.032-001
'rlrt1Irrt lrl1Irt llrr llrrr 1111111111111111111llrl'Irltlltl llrl p$-01032-00 PT SE SE II-3-910 AC
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
g Address(number and street,city,state,and ZIP code) Same as properly address(p 5 e') S ( 025t
Spouse First Middle Last
CoxK.r'e__ - S ur r
Mailing Address(Number and street,city,state,and ZIP code) 'Same as property address —
6 S?z/ 5 /UzS T
Each undersigned certifies,under penalty of perjury,that the above and foregoing information is toe 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 I Signature /t = Date )/ //D
- PART 4:ADDITIONAL INFORMATION
•
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Forth 5473 (R614-03)
Prescribed by the Department of Loral Government Finance
INSTRUCTIONS: See reverse side for riling instnutions.
'I, \
FORM � YEAR
F iHC1 a
2 2007 9)
L(We)�yy�%iMrre�- ss"r-:s?,- <,CERTIFICATION STATEMENT C " �"" "'C/i r certify the orfrm it t If of March, 20_
ccupied as our principal place of residence the following described real property for which a HomesteadtRope_ft Ta(rredjUiDfr€Ifby claimed:
e) 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.
kaeCONTRACT RECORDEDc :' '.Z_. ! R, rv.eA =Lis{'
If buying on contrail, Fee Simple owners name
Remmers office where contract is recorded Record number Page
"�
County
Township
Taxi is (city, town, township)
Parcel number
Leg scnp' Is the pro pe in ueston:
- oio3a-
_
� SF - properly ❑Mobile Home (I.C.6.1.1 -7)
If any portion of the residential structure or the
tun not exceeding one (1) acre that immediately surrounds that structure is used to produce income, describe the use and potion
of tthh�e property utilized to produce income.
16'�c
7✓Q�'�'`.p�a
- c7o -��-
c0- 661.03.2 -/Q'D/
' `" "'�F
S'T.�.`c."� sv
gi '- aT -.,r, %`.t? '�k: PROP.ERTXOWNEU'B1 caimANTINi6THER"COUNTIES+`r
County
' OM
HOMESTEADti
Township
County Township
I hereby certify the above statements are true, correct and complete.
Sig ture of claimant
ddre
ber and street, city, state, ZIP code) -
7t{/
i
e- ASSESSOR USE ONLY `
`' a+ °ivVAI.UEY
TRUETAX -rte
i c
- -
ASSESSED VALUE
' OM
HOMESTEADti
NON - RESID EN' TIAL
s';. e; nr.- h..,�,�;,^/,e.- _;,tt�... -`-
-€�_AT
100 %OFTSVfjV_ALUE���y�SIVALUE,
Land not exceeding 1 (one) acre immediately
(1)
ri7 +i,
surrounding residential improvements.
• =i InV
Other land
(2)
q, ,�� 'i~
Total land (line 1 plus line 2)
(3)
Dwelling
(q )
pF ^e s rySF
Residential improvements or Annually
"''`'3' ' ��
Assessed Mobile /Manufactured Home
Garage
(6)
_
c- :f
Other improvements
(6)A`.y-�w
Total 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 oUmditor
Date signed
STANDARD DEDUCTIONALLOWANCEE �.r
�T 20 Pay 20
Lesser of 112 Homestead
vauabon or E35.000
is
Signature of Puddw Date signed