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Homestead_Brucertx� CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT /STANDARD DEDUCTION. State Fonn 5473 (R2 / 5 -92) INSTRUCTIONS: See reverse side for filing instructions. FORM YEAR HC10 r ' '�'- RTIFICATION STATEMENT =: °7 -:`• ^, . --`' - , „-a L -1� /J _ / 801 Q1 17J I (We) . _. r _e �yvr L-9-7� e'//C.r x.... _ �.. ._.. certify tt'cHy of]March, 19 I (We) occupied as our principal place of residence the following described real property for which a Homestead P Tax C rit is /herebyMClai d: (We) owned ❑ Are buying under contract 66619 0 N y 1 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 oontn�t. •.. 'sr: ". -. CONTRACT RECORDED.... .�• ,•,E, .- ,..... r - !�`�•°"�,.. If buying on contract, Fee Simple owner's name Recorder's office where contract is recorded Record number Page - ' -- - PROPERTY DESCRIPTION County r T ns Taxing district (c own, township) - / Township I hereby certify the above statements are true, correct and complete. // �/ *an (number and street, city, state, ZIP code) rad,,6-1ja VALUE - •G�/ Parcel nu r Legal description /7 6 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 Townshp County Township I hereby certify the above statements are true, correct and complete. Sig to a of claimant *an (number and street, city, state, ZIP code) rad,,6-1ja ' ASSESSOR USE ONLY TRUETAX ASSESSED HOMESTEAD NON- RESIDENTIAL. .VALUE. VALUE. VALUE - VALUE r� Land not exceeding 1 (one) acre immediately_ - surrounding residential improvements. Other land 2 a: Total land (line 1 plus line Z) (3) Dwelling (4) G Residential improvements Garage (5) Other improvements (6) - Total improvements (line 4 through line 6) (7) Total value (line 3 plus line 7) (S) 1 hereby certify the above is true, correct, and Signature of Assessor Date signed complete. verifying action - Signature of Auditor Date signed AT.VE FOtSI 53,44,0u I 49. • • nrssum PoRV 7.IA AlPitnvEn BY 5115E BnARD(XMYY CM.`n. rttni-BED BY no DEPARTMENTOF LOLL COVERNMrNT FMK'E a'.-/.1-1:-S I 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 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 infomumon necessary to allow county government to better monitor homestead filintp.this information will be kepi cnnlidemial and can only be accessed by authorized county official.The Depannrem of Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud. PART 1: PROPERTY INFORMATION Taxpayer Name Property Address Bruce, Jesse R/Corellen Trust 104 Poplar Patoka IN 47666 491 Jesse R Bruce P O Box 17 State Parcel Number Legal Description PATOKA IN 47666-0017 �t�r t��rrr�t��tal��ttr lluil Ittt�� �l�tt t�t rr���rrr�a�r�t� 26-04-24-302-000.255-020 018-00255-00 COL DIV 24 PART 2:TAXPAYER INFORMATION Owner I First Middle Last J csse Robe-r4 13ru ce_. to Address(number mid itfect,city,state,and ZIP code)- — -_nn. _ -_ _ - !—1 Saweus property address— —- — -V D ox 17 /0+ PorIAr t'afokict, In 4-'764(0 Spouse First Middle Last Corelle n nru c.a. Mailing Address(Number and street,city,state,and ZIP code) n Same as property address Pc l PO Sox V7 I64- 'PopI&r 1 ok, !� 7(o lo, 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. p// Owner I Signature Date PART 4:ADDITIONAL INFORMATION I