Homestead_Ellis (4) %MI I ORM 539a,53 1 H0 113:ACURI1 IONM ISIA
.wovr evsn;E;o\Rn OF At LIRNfl.•o-+ PRIMRmtD BY UHLDIPARINF-v1 OF LOL4.cOVttwtN1 IL\ANCCIC-I.I'•-L:
Gibson County Auditor -IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS `..
101N. Main
Street Individuals and married couplo are limited to one homestead standard deduction.As the receipt of this deduction becomes
VILTMED more beneficial.there is more incentive than ncr for homistvtd fraud.Flomestead fraud causes higher tai.bills for all:therefore.
� IIEA 1344-_'MW requires lacpayers who receive the homestead standard deduction to verify that they are eligible to recei\e the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will be kept confidential and can only be accessed by authorized county officials.The Depanment of
2019 L
Local Government Finance will use this information to cruse tools that will help counts-officials eliminate homestead fmud.
NOV 9 PART t: PROPERTY INFORMATION= - ..•
C n� Taxpayer Name Location Address
Ellis, Stacy L •
GIBSON COUNTY AUDITOR 209 S MILL ST
I-AZLETON IN 47640 0
239 1
Stacy L Ellis 1101 1111011011111111011001101111.10111011.11.110110111011111-1111/111011111111
211 S Mill St
Hazleton IN 47640-9018
111111111111111111111111111111111"1111111"11111111111111111111 State Parcel Number Legal Description
26-02-59-032-000A18-019 BR 1ST ADD 32P1133 PT
This form MUST be returned to County Auditor's office.
Spou First Middle Last
I,C. ( 14 11 C,1lls
Mailing..drlossn((/N_y�ry'znd s'.rcct,city,state.and ZIP mode) Same as property address 0
. I 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.
Fai
•
PART 4:ADDITIONAL INFORMATION •
CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
CREDIT /STANDARD DEDUCTION HC7o n�
State Form 5473 (R2 15-92) �T4
eu
INSTRUCTIONS: See reverse side for filing instructions.
the following Acribed 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 property or is buying under a contract.
CONTRACT RECORDED
It buying on contract, Fee Simple owner's name -
Recorder's office where contract is recorded Record number Page
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
PROPERTY DESCRIPTION
County
eby certify the above statements are true, correct and complete. azure of
Township
r
Taxing dtstnct(a r. town, township)
Parcel number
4-ootl F -do
Legal de r lion
-
If any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that structure is used to produce into e. describe the use and portion
of the property utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
Sisk
Township County
eby certify the above statements are true, correct and complete. azure of
nt r
r
(1)
s (nwOer and street, city, slate. ZIP
LWJ
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 1 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)
(g)
I hereby certify the above is true. Correct, and
complete.
Signature of Assessor
Date signed
. action - Signature of Auditor 9
Date signed
STANDARD
19_Pay 19_
Lesser of 112 Homestead
S
Valuation or $2,000
Signature of Auditor