Homestead_PriestN* CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDIT /STANDARD DEDUCTION Hc�o
S State Forth 5473 (R418 -00)
INSTRUCTIONS: See reverse side for filing instructions. -
I (We) K J -1 �
❑ 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.
NTRACTnR __ECORDE_DW,j- j*�'.y�,
If buying on contract, Fee Simple owners name
Recorders office where contract is recorded. Record number Page
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- �� " "�`�`'a..PROt?ERTY,OWNED.BY�C
SCR_IP�TION'''.r �?`rZ''�
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County
Township Taunt
district ca4: town, to ip)
Ari (numfrera s7reeC dry, st ter, code) -
Parcel number
Leg escripbon
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...1_a t
Land not exceeding 1 (one) arre immediately
If any portion of the residential structure or the land not exceeding one (t) acre that immer ial*
of the property utilized to produce income.
I AML
unds that structure is used to produ8e in
me, describe the use and portion
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- �� " "�`�`'a..PROt?ERTY,OWNED.BY�C
ILA' MA'NT�IN Ole TFfER
County Township
County Township
�eby certify the above statements are true, correct and complete.
Signature or claimant
cril�ur
Ari (numfrera s7reeC dry, st ter, code) -
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Q!.A'S9ESSOE1ONY
20 _ Pay 20
ASSESSED 1V. A LUE
Q„r�aHO�MES- TEAD
.P NON `- ' RES "ID"E•N` TIAL -
-�,e" r+'VALUE"°�.ia..
( MEN-
AM100'/70�N
.
VALUE ?
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...1_a t
Land not exceeding 1 (one) arre immediately
(1)
'�
r_�;
surrounding residential improvements
:._ •i.,.- -_yp�y
Other land
(2)
Trial land (line 1 plus line 2)
(3)
Dwelling
(4)
s"'p�" z --.. r ~
Residential improvements
�s�xt -
Garage
(5)
,�('
Other improvements
f
(6)
Total improvements (line 4 through line 6)
(7)
Wvalue (line 3 plus line 7)
(8)
1 hereby certify the above is We, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
do
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vim`- .3'''�a a-4�S -sr` !- ';✓,s ; .r. STANDARD `.DEDUCTIONALLOWANCEi1t�.
20 _ Pay 20
Lesser of 12 Homestead
$
Valuation or $6,000
S to of Auditor
Date signed
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•
STATE[OEM•!NIR'INNI MAMMA EORV 731A
•PPROCEO By STATE BOARD Of Mitt c.9• PRr9[NBED BY int BEPARTf'4r(rt LOCAL r opt'irin EQ:,tiS'CE M6-I.I424.1
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 ester 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 receie the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filinta.'Ibis information will be kept confidential and gut only he accessed by authorized county officials.The Department 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 Properly Address
Priest, Richard/Randa
105 Mill ST
Patoka IN 47666
129
Richard/Randa Priest
Po Box 164 State Parcel Number Legal Description
Patoka IN 47666-0164
�� 11 I Ill I ��� 26-04-25-101-000.367-020 018-00367-00 BARNES ENLG
t
t o tot set set n n t ll t ton o il 92PT/93PT/98PT/99
This form MUST be returned to County Auditor's office.
Please do NOT send this form back with your tax payment to the county treasurer.
PART 2: TAXPAYER INFORMATION
Own First Middle Last
/Yid /7,/(51--
Img Address(number and street.city,state,and ZIP code) ❑ Same as property address
PART 3:CERTIFICATION c; ---�--- -_—
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
INFORMATION