Homestead_HorathCLAIM FOR HOMESTEAD PROPERTY iAX FORM YEAR
CREDIT /STANDARD DEDUCTION HCTD
♦ z Stale Form 5473 (R614-03)
Prescribed by the Department of Local Govemment Finance
INSTRUCTIONS: See reverse side for filing instructions
- ='> r': =" — CE_ RTIFICAT10NN/[SST`ATEMEN_T:. -
I (We) thatrdA4 e 1 st day of March, 20_
1 (We) o ed as our principal place of idence the following described real property for which a Homestead Property Tax Credit is hereby claimed:
❑ 1 (We) owned ❑ Ave buying under contract �
`�yyy ;o�'
6 GIB
Have a beneficial interest in the entity that is liable for the property taxes on the property and thatSOl!/ns�r� ^"DqoRing under a contract.
71 .re .";.. CONTRACT.iRECORDED:':.''_'.J _
If buying on contraw, Fee Simple owners name
Recorders office where contract is recorded Record number Page
._. =c>• �` -' - }3 —P--, `PROPERTY D
DESCRIPTIO' -- r
County T
Township T
Taxis d' . t (cit ,Yo , townshi )
Par 1 n ber
s�P n I
Is the property i question:
- O / W s
Real property ❑ Mobile Homo (I.C. 6-1.1 -7)
if any portion of the residential c
ce inc r
PROP ERTY OWN ED'BY CLAIMANT:IN.OTHER "COUNTIES'
County Township County •Township
I hereby certify the above statements are true, correct and complete. Sigrialuke of claimant
A4dre umber nd sheet, dty,stare, c e)
a K
° - TRUETAX ASSESSED VALUE - HOMESTEADiy NON- RESIDENTIAU
ASSESSOR{1SE ONLY -. , ,;
'r VALUE . -s „ -.. -. - VALUE - AT100ye- OF:TTV "'VALUE, -.� .,^.o-.VALUE :.
Land not exceeding 1 (one) acre immediately - ra S--
surrounding residential improvements.
Other land (2)
Total land (line I plus line 2) (3)
Dwelling (4) ` "f.i:_ . • ::` ..
Residential improvements or Annually Assessed Mobile I Manufactured Home Garage (5) - ¢- °:^.:i�`'f-= "•';.''� ' "�' _- _
Other improvements (6)
Total improvements (line 4 through line 6) (7)
Trial value (line 3 p1 line I) (6)
I hereby certify the above is true, correct, and Signature of Assessor Date signed
complete.
Verifying action - Signature of Auditor Date signed
Y• .:. 5 1<; ' -.- :' -i- ,- ' •: - STANDARD. DEDUCTION ALLOWANCE " -. - -: • ... " •. `, _ �• .
20 Pay 20
Lesser of 112 Homestead
Valuation or $35.000 $
Signature of Auditor Date signed
Y• .:. 5 1<; ' -.- :' -i- ,- ' •: - STANDARD. DEDUCTION ALLOWANCE " -. - -: • ... " •. `, _ �• .
20 Pay 20
Lesser of 112 Homestead
Valuation or $35.000 $
Signature of Auditor Date signed
• cl,rE RAM,,wla_t W.11 I1111N&EA FORM:3-1A
APPROVED litSIATE NNW OFACI:* T'.`VM PPFYA®En BY TIE DEPAKflOIT{f LOCAL CWVERVMneT FINANCE I41.1-224.1
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 incentive than e'er for homestead fraud.Homestead fraud causes higher tat bills for all:therefore.
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to recehe the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
flings.This informauon will be kept confdemial and can only be accessed by authorized county officials.The I)epanment of
Local Goremment Finance will use this information to create tools that will help comity officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taspaver Name Property Address
Horath, Virginia L
ram ground
Patoka IN 47666
1553
Virginia L Horath
201 E Apache Dr State Parcel Number Leant Description
PATOKA IN 47666-9005
III I I I I I I I I I I I II y 14 26-04-25-400-000.601-020 HUDSON FARM EAST 3
t tt tit t tit ttr tt t ,t t,t tt t tAPR rto, tZ010
O
GIBSON COUNTY AUDITOR
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
\J' I RC, )roIA L- . _ Hot n4 by
g Address(number and street.city state,ate,and ZIP code) — -- -- — ✓G Satre to property iddratn — — — - -- — -'
• n et? chP- DR PA4oR p 3-00 gc) 666
'
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as property aridness
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
sem
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.
Owner I Signature Date
Spouse Si a Date Telephone r l
PART 4:ADDITIONAL INFORMATION