Homestead_Warner4
CLAIM FOR HOMESTEAD PROPERTY TAF1L _ 1 . ` RM Y YEAR
CREDIT /STANDARD DEDUCTION _ APR 2 � 1992HC10
State Form 5473,(R2/1 -90) Ll�
- INSTRUCTIONS: See reverse side for filing instructionso �
GNrnAJ 9�
CERTIFICATION STATEMENT AUDITO
I (We) �tc1 i LL l V l /VCi)� certify that on the 1st day of March ,'19 ?5�
I (We) occupied as our principal place of residence the following described real property for which a Homestead
Property Tax Credit is hereby claimed: ( I (We) 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
El property or is buying it under a contract.
CONTRACT RECORDED
If buying on contract. Fee Simple Owner's Name
Recorders office where contract is recorded Record Number Page
PROPERTY DESCRIPTION
:LA I T nshi Taxing District (City, town, township)
Par Number al De ri tion
If any portion of the residential structure or the land 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.
1600- 1070 X800 , 3
PROPERTY OWNED,BY CLAIMANT IN OTHER COUNTIES
County Township .1 County
I hereby certify the above statements are true. correct and
Add e (Sir et number. city. state a d ZIP cQQ�)
ASSESSOR USE ONLY TRUE TA)( VALUE ASSESSED VALUE HOMESTEAD VALUE
NON - RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements
Other land
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 112 Homestead
Valuation or S1,500
(2)
Signature of Auditor
AAJ
(3)
Ded ^�
(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 1990
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 112 Homestead
Valuation or S1,500
Signature of Auditor
AAJ
Ded ^�
11
SLATE tORM!MID OC'l WO TREASURER FORM 111A
APPROVED BP XSTE BOARD OF ACTT SODA DPD PREYWAFD BY THE DEPARTMENT OF LOCAL GOVER,IMEN1 M ANCE M 1-1.1D41
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS •PRINCETON IN 47670 Individuals and married couple arc limited to one homestead standard deduction.As the receipt of this deduction becomes
,S more beneficial.there is more incentive than ncr for homestead fraud.homestead fraud causes higher tag bills for all:therefore.
• HEA 134-1-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to recene the
benefit and to provide additional identifying information neceser,ry to allow county government to better monitor homestead
filings.This information will be kepi 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 cotmn'officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
_ Warner, David/Debra
4997 F Gim Rd
Hazleton IN 47640
119 -
David/Debra Warner
4997 E Giro Rd State Parcel Number Legal Description
Hazleton IN 47640-9306
Illrrllttrlllirrllrrlllrrtlllrrrrllllltt Plllttllll1ltlElllllll 26-02-47-004-000.249-017/009-00249-00 PT LOC 4 1-10 4.29 AC
71
. - PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
� 4- 0 I C ol o t4 ed � c4-tio . •
•Lg Address(number and street,eit .state,and ZIP code) - -^ - - - -Er Same a ptopclly uddnass - — --
1 Cr 7 L G _; QD bed
Spouse First Middle Last
1)C 1.0 b f-ti, 5 ct. e___ Lt) A le-
Mailing Address(Number and street,city,state,and ZIP code) fj_s(me as property address
ggq7 E ( 1 20 pd.
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 additionalhomestead deductions
unlawfully,he or she may be liable for back taxes and substantial financial penalties.
Owner I Signature o Date
•