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Homestead_SharpCLAIM FOR HOMESTEAD PROPERTY TAX CREDIT /STANDARD DEDUCTION i State Form 5473 (R21 5-92) INSTRUCTIONS: See reverse side for filing instructions. FORM HC10 YEAR CERTIFICATION STATEMENT I (We) �- certify that on the 1 st day of March, 19_ I (We) occupied as our p cipal place of residence the following describ al property for which Homestead Property Tax Credit is hereby claimed: [A 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 property or is buying under a contract. CONTRACT RECORDED If buying on contract, Fee Simple owner's name Recorder's office where contract is recorded Record number Page PROPERTY DESCRIPTION County Township Taxing district (city, town, t sip) Parcel number L -a� L gal description I x� ao- 3- 13 If any potion 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 of ized to produce incorne. PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES County Township County Township Oereby certify the above statements are true, correct and complete. Signature of claimant Address (number and street, city, state, ZIP code) ASSESSOR USE ONLY TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON - RESIDENTIAL VALUE Land not exceeding 1 (one) acre immediately surrounding residential improvements. (1) Otherland (2) Total land (line I plus line 2) (3) Residential improvements Dwelling (4) Garage (5) Other improvements (6) Total improvements (line 4 through line 6) (7) Total value (line 3 plus line 7) (6) I hereby certify the above is true, correct, and complete. Signature of Assesor Date signed verifying action - Signature of Auditor ® STANDARD DFDIICTDN et 1 DWelar`c Date signed 19_ Pay 19 Lesser of 112 Homestead Valuation or 52,000 STATE roni55ft• r■741 EREASIIER 10PM:11A APPROVED DT ST ATE MAROC*ACmcertbu e.EYRTEDBY fir DEPMWMENT OF ICI'.LL r.ovr4'MG'r FR:ASCT r.-1.I-r-A.l Gibson County Auditor 101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS PRINCETON IN 47670 Individuals and married couples arc limited to one homestead standard deduction.As the receipt of this deduction becomes more beneficial.there is more incentive than eter for homestead fraud.Ilomestead fraud causes higher in bills for all:therefore. • HEA 1 343-21x0 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to recene the benefit and to provide additional identifyine information necessary to allow county government to better monitor homestead filing.This information will he Lev confidential and can only be accessed by authored county officials.The Department of Local Government Finance will use this information to create tools that will help went officials eliminate homestead fraud. PART 1: PROPERTY INFORMATION Taxpayer Name Property Address Sharp Family LLC RI Box 39 Griffin IN 47616 �� t 2672 / Sharp Family LLC CIO Wayne Sharp 6646 S 1675 W GRIFFIN IN 47616-9309 State Parcel Number Legal Description 11111111111111 1111111 111 r��t��ttt�t1 tt t�tt1 t11 t tt 1 t1 t� 26-16-20-200-000.166-023 D008-oolss-OO PT NE 20 3 13 1 A PART 2:TAXPAYER INFORMATION Owner I r First Middle Last mirAddtcss nber and'atroe— city.state.and Zi code) -—_ _ — " - — inmc as property taltia s _ _ ___ S CC) *' 1 �75 \n11 Gil PFrn -� 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 Pan 4 below) Sag 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. —