Homestead_Batesems•.. CLAIM FOR HOMESTEAD "PROPERTY TAX �� YEAR
ea4s ql
CREDIT /STANDARD DEDUCTION
State Form 5473 (R2/1 -90)
INSTRUCTIONS: See reverse side. for tiling instructions. MAY 0 6 199 1 _
CERTIFICATION STATEMENT
Maly (We) h'tir f 1✓( (� certify that on the Maly of March , 19 9
1 (We) occupilYas ouPprincipal place of residence fallowing described real property for which a Homestead
the
Property Tax Credit is hereby claimed: 1 (We),owned E) Are buying under contract
El property a beneficial interest in the entity that is liable for the property taxes on the property and that owns the
property or is buying it 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 (Ci y wn, towns
Parcel Number Legal Description
s v
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.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
I County I Township
I hereby certify the above statements are true. correct and I Signature
, city, state and 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
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)
f1J
1991 Pay 1992
19— Pay 19 —
Lesser of 1/2 Homestead
(2)
Lesser of 1/2 Homestead
Lesser of 112 Homestead
Valuation or $2,500
(3)
Valuation or $1,500
Valuation or $1,500
(4) -
-
- - -
(5)
S— _� 1
(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
1990 Pay 1991
1991 Pay 1992
19— Pay 19 —
Lesser of 1/2 Homestead
Lesser of 1/2 Homestead
Lesser of 1/2 Homestead
Lesser of 112 Homestead
Valuation or $2,500
Valuation or $2.000
Valuation or $1,500
Valuation or $1,500
Signature of Auditor
Date Signed
S— _� 1
.SIVE FORM!JV+lll'/Wr1 - 1RCASUtEA MIN TS-IA
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.APITOVEn BY SITE BfMRU Of'MCC:\TSY.w PRE:AIam BY TIE DEPARIhNr(W LOCAL COVELVMrhT FIANCE IC 41.1-24.1
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 eser for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
• HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to teethe the
benefit and to provide additional identifying information necessary to allow county government to better monitor homesead
filing.This information will be kept confidential and can only to accessed by authorized county officials.The Department of
Local Govenanent Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION .
Taxpayer Name Property Address
Bates, Jeffery A/Donna E
301 S Main
Patoka IN 47666
136
Jeffery A/Donna E Bates
P O Box 78 State Parcel Number Legal Description
Patoka IN 47666-0078
�t�t r��rrt�t��t rr��rtt��It��Irt��Lrr�rrr��rr�t�tt r��Lt�Lrtt III 26-04-25-102-000.015-020 018-00015-00 SMITHLAND DIV 9/10 PT
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
� LLAN 64-tff —,
fag Address(number and s city,state,and ZIP code) Same as property address
.7o ! /cl e;,. ®fY/4 ee 1,-/. y )cttt os 7( to Bo,b 'if
Spouse First Middle Last
;�'fOnneC E//et✓ •
Mailing Address(Number and street,city,state,and ZIP code) Same as property address
-
3o1 S 44 I/N EA t i t 7,.i (-176 6 C - r?o 7 t
70 o boy -ii
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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