Homestead_Bilderback 51•VE FORM!3'M IR_(5-Ni. 1PFAStRUR KOAV ZIA
APPMT=n BY STATE NNW OF,rt[nL'Tt_V.v PAFVLRIam BY TI.DFLARne4TOF tI*M r,ovtL'inT FM:ANCE ICSE1r-aI
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 ner for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
HEA 1344-3009 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 he kept cnnlidential and can only be accessed by authorized county officials.The Ikpanment of
Local Government Finance will use this information to cream tools that will help county officials eliminate homestead hand.
PART I: PROPERTY INFORMATION •
Taxpayer Name Property Address
_ Bilderback, Doris F
3rd&Mill
Patoka IN 47666
122
Doris F Bilderback
P O Box 307 State Parcel Number Legal Description
PATOKA IN 47666-0307
26-04-25-101-000.067-020 018-00067-00 BARNES ENLG 87
o II ut It II nII II rn II II t II to I nt III ut I nr I t I o II
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
02∎5 ` \ . 'U.\ ih erb (s-c_C__
tg Address(number and street,city,state,and ZIP code) Same as property address
o by. -3 Dr1 / — oko US. SAX tk - AC\b\41\ Th 4—\4Ao1a
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) I I Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
Sns
—
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.
Own I Signature Date
Spouse ignature Date Telephone
/
)
PART 4: ADDITIONAL INFORMATION
III
•
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
ri State Form 5473 (R2 15-92)
INSTRUCTIONS: See reverse side for filing instructions.
FORM YEAR
HC10
w -9 F 19Y
CERTIfICATI ST T ENT . AA FA
_ P -
I (We) 'fy that on t e 1s�tfd,1nayf1of March, 19_
I (We) occupi as our principal place of residence the following described real property for which a Homestead Preto# �4r4Mhereby claimed:
❑ I (We) ow ed ❑ Are buying under contrail
i
❑ Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns tl{fe cproperty.ociS buying and a o ract.
/ .I� p-,ntt rtoU.;°7Y AUDITOR
CONTRACT RECORDED
If buying on contract, Fee Simple owner's name
Recorders office where contract is recorded -
Record number
Page
PROPERTY DESCRIPTION
my
Township
Taxing dist ( town, o hip)
P I rrr _
Legal description TJ
If any portion o_flrthe residential structure or the land not exceeding one ) acre that immediately surrounds tha tr ture is used to produce income, describe the use and potion of
the property utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
County
Township
County
Township
:reby certify the above statements are true, correct and complete.
g of claimant
+
Address (number anyy street, city, state, LP code)
C� mlz.6 I 6 b1
ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON - RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
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 plus line 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
19_ Pay 19
Lesser of 1/2 Homestead
V uation or $2,000
S
Si t e of Audit
Date si ed
J-30-
u..