Homestead_Brown (2)c° °•'� YEAR
b CLAIM FOR HOMESTEAD PROPERTY TAX FORM
`sJ CREDIT /STANDARD DEDUCTION HCIo
• State Form 5473 (R215 -92)
INSTRUCTIONS: See reverse side for filing instructions.
FICA STATEMENT;" -,,� - r -.. . • .-
>.. CCECBo _2r.XAA �1_9.' -.949. .. ..
I (We) _ certitf laDO ` he 1 s[ day of March, 19_
I (We) occupied as our principal pla a of residence the following described r property for which a Homi&eacl Property/Tax§redit is re ciaimed:
❑ I (We) owned ❑ Are buying under contractYi�
- (I� ON tf�U . TY AUDITOR
4ave a beneficial interest in the entity that is liable for the property taxes on the property and that owns grope�Y or Is buying under a contract.
CONTRACT RECORDED,
If buying on con;raa. Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
PROPERTY DESCRIPTION
County
Township
Taxing district (city, town, township)
Parcel r
Legal description
ff any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that stru r is use 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
I hereby certify the above statements are true, correct and complete. S inatureoig4imant
ress num randsrreef, dry. state. ZIP code)
0 1-k rot S4. Pa kxaj
,.
® - STANDARD DEDUCTION ALLOWANCE°
19 —Pay 19_
Lesser of 1/2 Homestead
TRUETAX
ASSESSED
HOMESTEAD
NON - RESIDENTIAL
.- .ASSESSOR USE ONLY
--
VALUE
VALUE
VALUE
- VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)�
Otherland
(2)
.s .
Total land (line I plus line Z)
(3)
Dwelling
(4)
-
Residential improvements
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(6)
I hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
® - STANDARD DEDUCTION ALLOWANCE°
19 —Pay 19_
Lesser of 1/2 Homestead
$
Valuation or $2,000
Signature of Auditor
Date si ned
STATE FORS153,0. 1?-4M IRGNtD rORM g IA
.VPRm'ED BY STATE IIIIARDOI MreLTC9M PtLYRInmBY mr DEPARTMENT OF LOCAL GOVERNMENTI1NANCE tc I.1-r4.1
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 incenthe than ner for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
HEA 1344-2009 requires taxpayers s ho receive the homestead standard deduction to verily that they arc eligible to reeeise the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This infornalion will he kept confidential and can only be accessed by authorized county officials.The Depannent of
local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY LNFORMATION
Taxpayer Name Property Address
Brown, Larry G Jr
401 Mill \�
Patoka IN 4766p `�
563 v
Larry G Brown Jr.
P O Box 191 State Parcel Number Legal Description
PATOKA IN 47666-0191
11111 11111 11111111 26-04-25-101-000.119-020 018-00119-00 COLEMAN ENLG 7PT
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
L1l�it Beale a WA' SQ•
-g-Address(number end street,city,slim,and ZIP code)- -- - ' -- ' — - - --n Same as property - -
O. b//f/- 0/ !✓ectTA:ge(ST- '/7ccc
Spouse First Middle Last
Mailing Address(Number and street,city,state.and ZIP code) Same as property address
Social Security Number(last 5 digits) Drivers License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
Stine
PART 3:CERTIFICATION
Each undersign-4 c reifies,under penalty of perjury.that the above and foregoing information is true and correct and that he or she is eligible to
receive the ho -s-ad standard deduction on this property. Each undersigned also understands that,by claiming additional homestead deductions
unlawfully,h- o she may be liable for back taxes and substantial financial penalties.
Owner I Signs d•- Date
Spo Si. .ure t/ Date Telephone r l
PART 4:ADDITIONAL INFORMATION