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Homestead_Hoffman" CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT /STANDARD DEDUCTION � State Form 5473 (R2 /5-92) i I6 INSTRUCTIONS: See reverse side for filing instructions. FORM HC10 YEAR CERTIFICATION STATEMENT I (We) = ceiry tfie e1 st day of March, 19A. I (We) p e as our principal place c rest ence the following described real property for which a - e'$:I Pro Credit is hereby claimed: (We) owned ❑Are buying under contract (1(1 F-1 Have a beneficial interest in the entity that is liable for the property taxes on the property and that owpsLth jr6)eAgS%s buying under a contract. CONTRACT RECORDED I If buying on contract, Fee Simple owners name r�Gf2SOhC�''•�ar Recorders office where contract is recorded Record number Page PROPERTY DESCRIPTIO County - Township Taxing distrlc ( ry, r wn, to at I bar egal description If an 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 COUNTRIES County Township County Townshp �sgnature of claimant n �ereby certify the above statements are true, correct and complete. r Address (number and street, city, state, IP code) 7� 0 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 Valuation or $2,000 $ Signature of Auditor Date signetl • StATE 0RM5 ltS IIL'r MP0 'MEASURER FORM IS IA • .ArrR(WEI BY STATE enVloor MIA ecn.ano PU:FTInFOaT mr DFPARTIFYrfIF LtYAE GOVERNMENT FINANCE we .1-rat Gibson County Auditor 101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS PRINCETON IN 47670 Individuals and married couples are limited to one homestead sundard deduction.As the receipt of this deduction becomes more beneficial,there is more incentive than eser for homestead fraud.Homestead fraud causes higher tat bills for all:therefore. HEA 1344--2000 requires aapaycn who receive the homestead standard deduction to verily 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 confidential and ran only he acre:ud by authnrired county officials The Department of Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud. PART I: PROPERTY INFORMATION 0 Taxpayer Name Property Address Hoffman, Joe Main-Cross Patoka IN 47666 514 Joe Hoffman P O Box 84 State Parcel Number Legal Description Patoka IN 47666-0084 I rlrr llr rrlrllttrllrrt llrtl'ttl lltii llrlll lttl ltd ltrlrrllrrrll 26-04-24-303-000.262-020 018-00262-00 COL DIV OUTLOT 9 PT PART 2:TAXPAYER INFORMATION Owner 1 n First Middle last a)I — e_Address(number and street:city:sate;and ZIP code)- - -- — - - ❑ Same as property address--— ----- - - -- — _ . --. POg g4 P�hL 44, . cec Spouse First Middle Last Mailing Address(Number and street,city,state,and ZIP code) Same as propeny address Social Security Number(last 5 digits) Drivers License/Sate ID Number (last 5 digits) Other(please specify in Part 4 below) Sort 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. /�/ PART 4:ADDITIONAL INFORMATION •