Homestead_Maxeybo
CLAIM FOR HOMESTEAD PROPERTY TAX FoRfl
CREDMISTANDARD DEDUCTION
State Form 5473 (R7 I &M
Prescribed by the Depannent of Loral Gavernmard F� S
INSTRUC'nONS., See reverse side for Wing instructions. VTT IC T-N
I (We) ' A '4- M N"Xt / m* It" t4 At 4&h March, 20
1 (We) occupied as our "paj p&ce of residence the f0flaMng described real properly for t —
_tne�laad property Tax Credit is hereby claimed:
I (We) owned ❑ Am buying under contract
Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns 12�(�)!.pf/ir)�p(gryR contract
CONTRACT., RECORDED,`,'je,w'7.'t�
'j
It buying on mnbact. Fee Simple owners name
Rwxdees drxm wnwe cmtmd is recorded Bernd number Page
-.,P40PERVYOWNEDBY.CLAB&Pkttko*t3tcburdms!,..
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monk W.b ESCRtFrnOW
ty
Township
Tomrmtdp
Tatinl; district
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VALUE 6,!��,
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Land not exceedng 1 (one) am immediately
Pa=d
'a�
pW"
in question
—
_0 �QS 304.0
0 QS a
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MF�pm pop" [I while Fi.ma y.c. 61.1 -n
If any portion of the residential structure or the land nal exoesdug we (1) acre that rnnux6awy surrorawls OW sAkture
is used to produce immure, deambethauseend portion
of the property Uff=d to produce amxne.
-.,P40PERVYOWNEDBY.CLAB&Pkttko*t3tcburdms!,..
County
Township
ty
Township
1 hereby certify the above statements are true, coned and complete.
WIM9 MM"
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ONLY b&
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;kON4tESlVEN71AL-.T,, i r
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VALUE
VALUE 6,!��,
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Land not exceedng 1 (one) am immediately
.7'V_k1 V"I
sunouriding residential nnprovernents.
1'zi
Other land
(2)
Tctaf land (fore I plus &* 2)
(3)
Dwelli rig
(4)
Residmidalirnpromnents or Annually
�'X
AuRsessed Mobile I Manufacturad Homo
Garage
(5)
5" �tq
Other improvements
(6)
Trial arpnNements (fine 4 Uvough Eno 6)
(7)
Trial value (firm 3 pks fins 7)
(8)
1 hereby certify the above is true, correct and
conviele
SWWAure of Assmsmx
Date Signed
VerrlpN action - Signature of Auddar
Data Aged
"<r STANDARD DEDUCTIONALLOWANCF,
20_Pay2O_
Lesser of 12 Horneslead
Valuation or M.000
-o16
MALE I ORM!3 W,IC/s-o.0 ISFASUAEM TORN:SIA
APPROVED m"xroLoo,,nCIF Myy L% n. on PALMDFD BY TIEDEPMTYEYrlf Lb:LL CrOV21MMrWr f PALACE Ws-IA-224 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 aandanl 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.
III HEA 1344-2000 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
tiling-.This information will he kept confidential and can only be accecsed by authnrited county officials.The Depann,enl of
Local Government Finance will use this information to create axis that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Maxey, Joseph R/Constance P
628 MOCIIICAN DR
Patoka IN 47666
636
Joseph R Maxey
628 Mochian Dr State Parcel Number Legal Description
PATOKA IN 47666
26-04-25-302-000.621-020 HUDSON FARM EAST 19 PT/20 PT
X
PART 2:TAXPAYER INFORMATION
Owner I �O C e c h First — O y Middle 6 X ey Last
g Address(numberr and strei'C city,state,and ZiP code) -- - -- - -- — --' Swine In trrooperty addra.. -
��
AO 5. (U\ D in ic, r 14-4-0 K - Z-10 4764
.
Spouse First Middle Last
Con 57 PeeC-e �f�-�rlc(t� ��� 4Xcam)/
Mailing Address(Number and street,city,state,and ZIP code) 0ir Scone as property address
to 5, ` h0hl AarD r�'o A$bKA T■-) 47G4L .
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
nlawfullv,he or she may . . - or back taxes and substantial financial penalties.
S _•' Date
PART 4:ADDITIONAL INFORMATION
7- -