Homestead_Georges (5) ei��� CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDIT/STANDARD DEDUCTION HC1Otij'.
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State Form 5473(R2/5-92) t L4 F ,fi 11 (
INSTRUCTIONS:See reverse side for filing instructions.
CCq n - e,,
.. • . -- . - CERTIFICATION STATEMENT.' t: .a..
I(We) • 9.1 '-'t _ �. - x . 1 - certify that Vie,lst fay of March. 19 L 1/
it P place following property perty" j y_` '�v,March. +v
�_)occupied as our �� ncipal lace of residence the followin described real for which a Homestead Pro hx Creditis,hereby dalmep: ,
(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.
If buying on contract.Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
PROPERTY DESCRIPTION - ^' `- _. -
County Township ing district(city,town,township)
F>
Parcel number Legal description
Il
aps boa-7o- as 07(0 -dO-3(n - o - 400. ,32o -007
If 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
Oreby certify the above statements are true,correct and complete. Signatur c ai
��1
Address(number and street city,state.ZIP code)
kP ZRed 2 ) � i n L/4 /tit .Litt t/76/9
' ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD- . NON-RESIDENTIAL.'
VALUE VALUE VALUE . VALUE
Land not exceeding 1 (one)acre immediately - .-- --
surrounding residential improvements. (1) - • , o
Other land (2)
i,s -
Total land(line I plus line 2) (3)
Dwelling (4)
Residential improvements
Garage (5) .
Other improvements (6)
Total improvements(line 4 through line 6) (7)
Total value (line 3 pbs line 7) (8)
I hereby certify the above is true,correct,and Signature of Assessor Date signed
complete.
Verifying action-Signature of Auditor I Date signed
rl
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STANDARD DEDUCTION ALLOWANCE' ., 41 '
19 Pay 19
Lesser of 1/2 Homestead
Valuation or$2,000 $
Signature of Auditor
Date signed
STATE FORM 53569(R35-10)
TREASURER C6-1.l TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS.2009 PRESCRIBED BY TEE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-I.I:2-8.1
IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS , r
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 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 eligible 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 Local
Government Finance will use this information to create tools that will help county officials eliminate
homestead fraud.
;' ' M. PARTI PROPERTY.INFORMATION .:". ■ &il, ,' .. _ „"x:
Termer Name Property AddrrE9 State Parcel Number J.eval Description:
•
Robert V/Katrina K Georges 10457 S 1150 E 26-20-36-400-000.370-001 PT SE SE 36-3-9 5.01 AC
LYNNVILLE IN 47619 D-19
Complete and return to: IPTIIIIIIVI nJIIII[MMIIJ!!im,i:JftI SEEIBIE- -
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
- . , PART 2:TAXPAYER INFORMATION - -, . 14. r"
Owner 1 Forst Middle Last
� 1C k - Vim,)I se ay 5
Madolag Andress(number and street,aty,state and ZIP cede)
yel Same as property address
,k/n-)r i n n /l e/ eery-le 6
a,...- " �'. 1, ; .,. .4. -."ir a :irs``t PART 3'b RTIFICATION'.1?_IF ., j :411."`:+'' h: -
- _- �= � _..r—_. � ,.-r-I-:ems—.
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 Signature Date
:
ter.
JAN 2 - 1u13
• Tl w' N`Ty pupITOR
010:,047 COU