Homestead_WheatleyCLAIM FOR HOMESTEAD PROPERTY TAX
CREDMSTANDARD DEDUCTION
State Form 5473 (R7 I 5-M
Prescited by the Department of Local (3,avernmerd Finance
INSTRUCTIONS: Sea reverse side for Ming ins•ucdom.
CERTIRCASM STATEMENT-:"'
r
- 011 is
h W.
I (We) Lj1iajnA &t-/ / / La I J�� certify that on the I st day of March, 20_
I (We) occupied as our principal place of residences the foliowi real property for which a Homestead Property Tax Credt is hereby claimed:
owned El Are buying under contract 71��
Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property "is buying under contract.
A-f
'1i` CONTRACT!RECOROED,61,et
If buying on cmtraM Fee Simple ow mes nam
Reawdees ar& where contrad m reoxded Record number Page
Nlw� • "W'T
ti PROPERTY DESCRIPTION
Township
County
Taimstup
Tmng d
I M Z imimZE
pwnsfup)
Parcel number
Leo description
Is the pimparty
in questio
I
pf-W
pi�6.rty ❑ Mobile Home (W. 61.1-7)
If any portion of the residential structure or Die Lend not exceeding one (1) sons that immediately surrounds that s6ucGe
is used to produce hoorne. describe the use and portion
of the property utilized to pmdw income-
14
a (o- 0 Q - L' r-
6G ,;� - 7
Nlw� • "W'T
County
Township
County
Township
I hereby certify the above statements are hue, coned and complete.
of dairni"L
(numter
jr i tv 1? 3 j 6 /:5; Dom -z:-,/v - el 7 Z, 41 o
i,C*L*
ASSESSOR USE
qW 20_Pay20_
ASS
HOMESTEAD
lAgLUEMVWZ�&
$
AT 100% OF
Signature of Au&tor
Date signed
Land not exceeding 1 (one) acre immedately
14
surrounding residential improvements-
Other land
(2)
Total land (fare 1 plus Ins, 2)
(3)
Dwelling
(4)
Residential improvernerits or Annually
M
Rim
Assessed Mobile I Manufactured Horne
Garage
(5)
Other improvements
(6)
�-k
Total improvements (roe 4 ftough fine 6)
(T)
Total value (1irie 3 pots fine 7)
(8)
I hereby certify the above is true, correct, and
Signatiffe of Assessor
Dale signed
complete.
Varlying adjon - Surature of Audflor
Data signed
IsTANDARo DEOucnom ALLOWANCE OWAN cE
qW 20_Pay20_
Lesser of 12 Homestead
$
Valuation or 535,000
Signature of Au&tor
Date signed
MATE FOAM!!.wIR/i-Pt TnEANEEA FORM 7-IA
AerKIR'ED BY MATE B I DO,MYTR A.`-t% rRFRNBED BY nut BErARMCn OF tXR'AI GOVERNMENT FINANCE IC 0.410-'4.l
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 exer for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
® HEA 1344-2000 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
benefit and to provide additional identifying information necessary to allow county genertmment to better monitor homestead
Mingo.This information will he Lep confidential and can only he accessed by authorized county officials.The Depanntent 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
Wheatley, Grant
10831 N 500[:
Ilazleton IN 47640
15
Grant Wheatley
10831 N 500 E State Parcel Number Legal Description
Hazleton IN 47640-9312
�r�tt��trE�t��rtt�rr���ttt�r�t trr��rr rr��rr�t�r t��tt rt����ttr� 26-02-47-002-000.952-017 009-00952-00 BUENA VISTA 5/6/10PT
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.
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
G-;g9 f/L-1-T Ey
tg Address(number and street,city,state,and ZIP code) ® Same as property address
1983//(5co ' /bIz c -77V-i76 Y,
Spouse' First! Middle Last
Mailing Address(Number and street,city,state,and ZIP code) Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
sae �—
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