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CLAIM FOR HOMESTEAD PROPERTY TAX veAR
+- CREDIT /STANDARD DEDUCTION tmo ` State Form 5473 (11817 -07) 8
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
I (We) daAx � Li✓ q zy_a c L zal-_ certify that on the 1 sl day of March, 20_
I (We) oj6upied as our principal place of residence the following described real property for which a Homestead Property Tax Credit is hereby claimed:
1 Q 1 (We) owned ❑ Are buying under contract
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 contract.
Parcel number L/a�ga�l�desc/r /inp/ti�o�n-� /� Is the property in question:
(�/�(,� F-� &-zj& . j�' 16 1x11 ❑ Real property ❑ Mobile Home (IC 61.1 -7
If any portion of the residential stnxture 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.
,��•oy- a.y -3o3 -Boo. oS.3 -pa.o
zu _ pay 20 _ 45,000 for 2007 pay 2008 42,000 for 2010 pay 2011
Lesser of 112 44,000 for 2008 pay 2009 41,000 for 2011 pay 2012
Homestead Valuation S
w 43,000 for 2009 pay 2010 40,000 payable after 2012
Signature of Auditor Date signed (month, day, year)
Land not exceeding 1 (one) acre immediately
T`
surrounding residential improvements.
Other land
(2)
Total land (line 1 plus line 2)
(3)
Residential improvements or Annually
Dwelling
(4)
-
Assessed Mobile / Manufactured Home
-
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 We, correct, and
Signature of Assessor _
Date signed (month, day, year)
complete.
Verifying action - Signature of Auditor
Date signed (month, day. year)
zu _ pay 20 _ 45,000 for 2007 pay 2008 42,000 for 2010 pay 2011
Lesser of 112 44,000 for 2008 pay 2009 41,000 for 2011 pay 2012
Homestead Valuation S
w 43,000 for 2009 pay 2010 40,000 payable after 2012
Signature of Auditor Date signed (month, day, year)
STATE FORM 5351a ilk: TRFANIEA FORM TS-IA
.APPROVED BY STATE BOARD OFMR%l\TS.1,04 PREAAmED BY TIIE OEPART(EVI OF LOCAL GOVERNMENT FINANCE It I-1.I-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 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 recene the
benefit and to provide additional identifying information nee—L.—.,y to allow county government to better monitor homestead
filings.This information will he kept confidential and an only be accessed by authorized county officials.The Depanmenl 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
Hull, James Robert/Dacia Rae
P 0 Box 63
_ Patoka IN 47666
500
James R Hull
P O Box 8 State Parcel Number Leea1 Description
PATOKA IN 47666-0008
I I III I I I I I I I I I I I III I I III 26-04-24-303-000.053-020 018-0005300 COL DIV OUTLOT 16PT
I u ul I 111 nl n nl III lu Il l trl rl Il F I
PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
Tames `Mabee- Hu LL
_e IA-d dares(number and stye- yin;smte,and ZiP code)--- -— --- t[ Sameas property red t- — — -----
210 &cK tot Pc to K IN 41 666
Spouse First Middle Last
Mailing Address(Number and street,city,state.and ZIP code) Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(phase specify in Pan 4 below)
sag
PART 3:CERTIFICATION
Each undersigned certifies,under penalty of petjury,that the above and foregoing information is true and correct and that he or she is elieible 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 1 Signal Date
Spouse mature Date Telephone ( l
PART 4:ADDITIONAL INFORMATION