Homestead_Mays (2)CLAWFOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDIT /STANDARD DEDUCTION
State Form 5.473 IRS 14-03)
Prescribed by the Department of Local Govemmimt Finance -Pin- ic T-%
INSTRUCTIONS: See reverse side for filing instructions.
I (We) I 10Q - T VIAA- [I I J2�,Ia certify thWthl 4 49 March, 20_
1 (We) occupied as our principal �Lce'of resident 4jhe following descrifted real property for which a Homestead PTP�irty Tax Credit is hereby claimed:
I (We) owned ❑ Are buying under contract
L
Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns contract.
3Z . CONTRACT•RECORDED-,'!,��,
If buying on contract. Fee Simple owners name
Recorders office where contract is recorded Record number Page
--t-1PROPERTY '. DESCRIPTION
County
Township
Taxing district (city, to", township)
Pale bet
tA-Z
L
�V&,4
the property In question:
E) Real property ❑Mobile Home (LC. 6-1.1-7)
If a portion of the residential structure or the land not exceed' ncs that structure is used to Produce income, describe the use and portion
of th! property udlEzed to produce income.
PROPERT-YCiWNEE�BYiCLAIMANT;IN'�OTHEFt-COUNTIES *�s
County Township
County
Township
I hereby certify the above statements are true, correct and complete.
Signature of claimant
,eress (number and street, city, state, ZIP code)
M
?TRUE TAX r W�t7
SS96VAEGE
AS6E7
U HOMESTEAD
01
S
0 % dF,T-1V
'—'--VVALU
��'��',7..NONIRESIDENTIAL,�.���"-,
Date
I Z,
Land not exceeding i (one) acre immediately
all
surrounding residential improvements.
Other land
(2)
Total land (line I plus line 2)
(3)
Dwelling
(4)
Residential improvements or Annually
Assessed Mobile I Manufactured Home
Garage
Ooer improvements
(6)
Tdal Improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(8)
1 hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
STANDARDMIEDUCTION ALLOWANCE;, —f-
20 Pay 20
Lesser of 112 Homestead
Valuation or 535,000
S
Signature of Auditor
Date
U W
f.
R,-,
SLATE FORM!!NIR./Nrvl ThF t11tDA FORM i}IA
APPKrWED or cpat.1K111100f ACCOUNT,.20N PlIrtIPn1 BY TIE DErART6Yr W LIXTL CaTRNSI NT INANCE IC 41.1-Lai
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 exec for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
Mr HEA 1344-7009 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 allw'county government to better monitor homestead
filings.Otis information will be kept confidential and ran only be accessed by authorized county officials.The Ikpanncm of
local Government Finance will use this information to create a015 that will help couny officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Mays, Tammy Kay
303 W Vine
PATOKA IN 47666
521
Tammy Kay Mays
PO Box 95 State Parcel Number Legal Description
PATOKA IN 47666-0095
'tut tll tttlt lltrtl Iii,lluil(III III uuluI ltd ltluI.Iuu tluIiiuI IiI 26-04-24-303-000.610-020 018-00610-00 Col Div Ouuot 8 Pt
• PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
F KNe
-- ig A-drds(number ands city;state;and ZIP code) - • me as proper)-adds; - - • - - — -- —- -
Social Security Number(last 5 digits) I Driver's License/State ID Number (last 5 digits) Other(please specify in Pan 4 below)
sou
Spouse First Middle Last
Mailing Address(Number and street,ciy,state,and ZIP code) ❑ Same as property address
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 Telephone
•