Homestead_JohnsontI
a. ^m
b CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDIT /STANDARD DEDUCTION HC10
State Form 5473 (112 / 5 -92)
uu
INSTRUCTIONS: See reverse side for filing instructions.
CERTIFICATION STATEMENT" •_ :_. - -. .. .
I (We) _ certify that on the 1st day of March, 19
I (We) ied as our principal place of reside the following described real property for which a Homestead Property Tax Credit is hereby claimed:
kiI (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.
CONTRACT RECORDED
It buying on contract, Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
ASSESSOR USE ONLY
PROPERTY DESCRIPTION -
County
Township
NON - RESIDENTIAL.
Taxing district (aty, town, It
VALUE
VALUE
VALUE -
VALUE
Parcel number
Legal dewtipt
surrounding residential improvements.
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.
ASSESSOR USE ONLY
TRUE TAX
ASSESSED
HOMESTEAD
NON - RESIDENTIAL.
- -
VALUE
VALUE
VALUE -
VALUE
Land not exceeding 1 (one) acre immediately
Date signed
1—
surrounding residential improvements.
(1)
Otherland
(2).;
•s ;, -., -° -
Total land (line f plus line 2)
(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)
(g)
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
S
Valuation or $2,000
Signature of Audit r
Date signed
1—
STArt FORM!3N.lten-gn TREASURER RAM TS-IA
.APPRrr.'En BY STATE BOARD OF NYY*Ntc'tu PRIS(RIBm BY THE BEPARF?R_YT OF LOCAL IXI ZRNMENT FINANCF.IC 11-1.1-224.1
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 oar for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
® HEA 1544-1009 requires taxpayers who receive the homestead standard deduction to verify 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 can only he accessed by authorized county officials.The Depanment of
Local Government Finance will use this information to create owls that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Johnson, Raymond C/Teresa A (a(a S. OLD pAja(Ln RD.
R T.- In -
Patoka IN 47666
646
Raymond C/Teresa A Johnson
626 S Old Patoka RD State Parcel Number Legal Description
Patoka IN 47666-9002
I r lrriirttirii ul_Arl__11,1_11_,111_,llrtrltlttltltllttttltll 26-04-25-400-000.558-020 018-00558-0o PT SE 25111too AC
• PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
RAYMOND eARL To Ht\IS0N1
••FB Address(dumber and street,city,state;and ZiP ebde) - - -- — - - E6ame as property address---- -- - - -- -
co au S . OLD PAIDe.a ROAD PRIM id_ici 1 LA.I. / 7(o (o (o
Spouse First Middle Last
TERESA /ANA/ LTD HNSo 0
Mailing Address(Number and street,city,state,and ZIP code) Sane as property address
(0r9 (n S . Ow eAToRA Ron I) PR foil& 2n/ . yrpac., o
- - — — — —
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 des ction on this property. Each undersigned also understands that,by claiming additional homestead deductions
unlawfully,he or she may be liabl, or back taxes and substantial financial penalties.
Owner I Signature Date
(
PART 4:ADDITIONAL INFORMATION
7