Homestead_Belcherea�1� °g CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 182 15-92)
uu .
INSTRUCTIONS: See reverse side for filina instructions-
t=
°r
;/�- � ' 6 <I A 4 g J certify that on the 1 st day of March, 19
as our principal place of residence the following described real property for which a Homestead Property Tax Credit is hereby claimed:
Ie�-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 DESCRIP ION --
County -
Township
Tat) dis ict I# to n, tow ) -
Pa Go
Legal description kOl
It any portion 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 utilized to produce income.
- PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES '
County
Township
County
Township
l &,by certify the above statements are true, correct and complete.
S natur of claimant,
Signature of Auditor Date signed
t, city, state, ZIP d
Address (L(p number and stree an
ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON - RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Signature of Auditor Date signed
-"
Other land
(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 pUs line 7)
(3)
1 hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
Lying action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19 Pay 19_
Lesser of 1/2 Homestead
Valuation or $2,000
S
Signature of Auditor Date signed
•
STATE FORM 5150 01r/&l0) 'MEASURER FORM 15-1A
• APPROVED BY STATE BOSRO OF M'OIUNTS-SW PRESCRIBID BY TIIEDEPARMEST OF LOCAL CAyER YMEYTMXANCE ICSI.14211
Gibson County Auditor IMPORTANT NOTICE 7'O HOMESTEAD PROPERTY OWNERS
101 N. Main Street Individuals and married couples are limited to one homestead standard deduction. As the receipt of this deduction becomes
Princeton, IN 47670 more beneficial,there is more incentive than ever 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 eligibk to receive 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 Department of
FITI Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
1 I C I i ,L PART 1: PROPERTY INFORMATION
Taxpayer Name Location Address
•
• AUG 0 4 2011 Belcher, Ike R/Garie L
Ivmv_--��22---- 404 Main
C'�•.'^�C�-� Patoka IN 47666
495 V v\
Garie COUNTY AUDITOR II 1111111111111111111111111111111 I 1 11111111(111111 II II.11111011-1010111 II
Ike R/Garie e L L Belcher
P O BOX 223
Patoka IN 47666-0223
I'I'Ill'I'I IIIIIIIII"IIIIIIIFIPII'llllllllllll'Illl'Il'FIIIIIFII State Parcel Number Legal Description
26-04-24-302-000.184-020i COL DIV 54PT CONTRACT TERRY W
PAGE
5
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.
- A?P4I°RIJFOR. 1A1ION _
Div er 1 First Middle /t --_— Last
Mailing Address(number and street,city,state,and ZIP code) Same as property address
PO e° ` DPa3 Pr - tizceco
Spouse First Middle Last
CA-Q Imo. S (Be Ic Kier
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as property address•
___ PO BOX (9 a3 ?,Maki- s� t1 %( 4
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 1 Signa Date
PART 4: ADDITIONAL INFORMATION
•