Homestead_VanvlietNn
CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
CREDIT /STANDARD DEDUCTION ���g 2 2 Or
S State Form 5473 (R418 -00)
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INSTRUCTIONS: See reverse side for filing instructions.
CERTIF,lC�AT1g.N TA'IF_MENr --�-` s ,.�.. = •w:._ .. ,
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I (We) �/ Q —x� t IL —t r ra o certify that on the 1st day of March, 20_
I (We) occupied as our principal place of residence t e following described real property for which a Homestead Property Tax Credit is hereby claimed:
owned El Are buying under contract
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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.
�. .•. .^v. t = ' yet ,'-ez ,_.,u,• ""•i� x'°_ec, NT Wj: TT RECORDED:n_ ,s.. ¢' -' -' 5�`�sc�- �.:.""m:• -=s-�' '- z
It buying on contract, Fee Simple owners name
Reoxrders office where contract is recorded Record number Page
. 3, �3•^
y "��j,?'vPgOPERTYFD_ESCRIPTIO.N'
County
Township Taxing district (city, I con, township)
Parcel number
Legal description.
" "dress
,MOT and street city state, ZIP code) -
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If any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that structure is used to produce inmme, describe the use and portion
of the property utilized to produce income.
PROPERTY, %OWNm BY CLAPA_
NT IN_ OTHER COUN7_IES¢ ,�_..• `�JJ��� n.,;z,'- - r�i°i�+f'
County ,. Township
County Township
I hereby certify the above statements are true, correct and complete.
Si not a of cl aimant ,
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,MOT and street city state, ZIP code) -
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'7.`° ASSESSOR'`U_SE�O_NLY -''
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TRUE'TAX
ASSESSEDIVALLIE
"�ATw100Yo'OFhTiNVALUEy,�
M �HOMESTEA
r: NON�RESIDE" AL .
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VALUE
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Land not exceeding 1 (one) acre immediately
(1)
.mss,.3
surrounding residential improvements.
'r �;L ..".-
Other land
tmr`
r
Total land (line 1 plus line 2)
(3)
Dwelling
(4)�a1x
"°"ra
Residential improvements
3s�
Garage
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,
MAID- J 3F a.tiTZ R
Other improvements
(6).:?�-
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Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(8)
hereby certify the above is We, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
• i.;v- i•,l;,,.�'"y"tut?;q' STANDARD`. DEDUCTIONtALLOWANCEy '.,,ps>°- '•,' *„:;`
20 _ Pay 20 _
Lesser of 12 Homestead
$
Valuation or $6,000
Signature olAuditor Date signed
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STATE FORM SA(E
TRLASUPIR FORM IS-IA
APPROVED Y STATE BOARD
Or ACCOUNTS x109 PRESCR IBED BY THE nEPARMEAi OF 1AGLGOYFalAMEYI FlRA`IQ IGLI.1-}11.1
Gibson County Auditor . IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N. Main Street Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
. Princeton, IN 47670 more beneficial,there is more incentive than ever for homestead fraud.Homestead fraud causes higher tax bills for all;therefore,
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
Ili benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
F 4�� filings.This information will be kept confidential and can only be accessed by authorized county officials.The Department of
1 Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFOR:\IATION
MAY 6 2011 Taxpayer Name Location Address
Vanvliet, Ernest B
C.1).16 7984 E 450 N
10A3IBSON COUNTY AUDITOR
FRANCISCO IN 47649
Ernest Bban lief II110111.011011]I1.111101 Bill mull DIII1 11.11101-11.1111101101110101111
7984E 450 N
FRANCISCO IN 47649-9243
1Itlllt1llllttlll1ttllltll1'II1I'I"II'IIIII'IIII"I'll'IIII" State Parcel Number - Legal Description
26-06-16-200-000.634-017�PT SE SW 16-1-9 10.18 AC C-1
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This form MUST be returned to County Auditor's office.
Please do NOT send this form back with your tax payment to the county treasurer.•_•________pAjx.2• ' 'P YERINFORDIATION _
Ow...r I First Middle
Last
EiC 1\ -I-- 6, -„,),,,, /1`t \ V/L- e't—
Mailing
Address(number and street,city,state,and ZIP code) DISame as property address
1984- 5 LISO 0 freinc_ifcu .-L- N y 6Lici
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as property address
Social Security Number(last 5 digits) Drivers License/State ED Number (last 5 digits) Other(please specify in Part 4 below)
1 1 1 1 1 1 1 1 f I Stee
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. .
Owner I Si Date
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PART 4: ADDITIONAL INFORMATION