Homestead_WallaceSi iFO
CREDIT/STANDARD CLAIM FOR TDEDUCTION PROPERTY TAX
State Form 5473 (R2/5-92)
INSTRUCTIONS See reverse side for filing instructions.
HC109 i . YEAR
11 MAY 10 i2001
;r
CERTIFICATION STATE NT. /
(We)
��utn�����ra
rt(QI"dil`N4'eLVIT�a0ornn�TG1, 9_
I (We) occupied as our print' al place of residence t following described real property for which a Homestead Property Tax Credit is hereby claimed:
❑ I (We) owned re 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.
CONTRACT RECORDED
It buying on contract, Fee Simple owners name
Recorders office where contract is recorded
Record number
Page
PROPERTY DESCRIPTION
Cou
Township
-
Taxing distri ct o own
arcel 0()9-03 e 1 S -3 —1 lJ
�/y�
/shipLl /l
T,
Legal de I
If 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.
'
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
County
Township
County
Township
Signature of Ganent
Sreby certify the above statements are true, correct
and complete.
..odress (number and street, city, state, ZIP code,
l3 Ica oioKci._ T7,
q 7
ASSESSOR USE ONLY
TRUE TAX
ASSESSED
HOMESTEAD
NON - RESIDENTIAL
VALUE
VALUE
VALUE
VALUE
Land not exceeding 1 (one) acre immediately
(1)
surrounding residential improvements.
Otherland
(2)
Total land (line I plus line 2)
(3)
Dwelling
(4)
-
Residential improvements
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(8)
1 hereby certify the above is true, correct, and
Signature of Assesor
Date signed
wmplete.
Vedtying action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19_ Pay 19
Lesser of 1/2 Homestead
$
Valuation or $2,000
Si t e of Auditor
Date signed
v-o
MATE FORM!MONBr 5-trq TREASURER TORN TS-IA
, AP Pwwtn BY STATE B ,sDOFACMUS'R.9r', Ptr_YR1am BY TIIr DEPARTMENT OF tent r vtrrener FIANCE ICs-1.I.22rI
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individual and married couple are limited to one homesead 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 tat bills for all:therefore.
s \ HEA 1344-2000 requires taspasers who receive the homestead standard deduction to verify that they are eligible to recei a the
benefit and to pm'ide additional identifying information nemstrs to allow county government to better monitor homestead
\ filings.This information will be Lepi confidential and can only be accessed by authorized county officials.The Department 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
Wallace, Harry E/Cynthia M
400 N
•
Patoka IN 4766 — _
760
Harry E Wallace
2749 E 400 N
Patoka IN 47666-9204 State Parcel Number Legal Description
26-05-22-300-003.158-017/0009-03158-00 PT SW 22-1-101.20 AC
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
Harr ace_
aE Address(numbdr and scree city.state,and ZiP code) - _ _ .. _ Imo-Same as proper.}'uddress --_ _ -- - -
Spouse First Middle Wallace
Last
�ynfh% e_
Mailing;Address(Number and street,city,state,and ZIP code) 121 Same as property address
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 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 ' " � Date
PART 4: ADDITIONAL INFORMATION
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