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ARRm'F➢BY AVE YMRDOFARTRMP.!✓r PR:SCRIBE BY THE DFPARTNeNT{ LtxAICAhrRNY.rta FINANCE ICH.I-22-1.1
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N Main 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.IFomestead fraud causes higher tax bills for all:therefore.
HE.\ 154-F-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to recent"the
benefit and to provide additional identifying information necessary to allow county goverment to better monitor homestead .
Glints-This infnrnution will he kept confidential and can only be accessed by authorized comity officials.The Iepannent of
Local Government Finance will use this information to create tcxds that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION -
Taxpayer Name Property Address
Rostron, Judith G
Main
Patoka IN 47666
522
Judith G Rostron
304 N Main State Parcel Number Legal Description
Patoka IN 47666-9515
I I III I I. I I I I I I I I I I I I I I I I I 26-04-24-304-000.001-020 018-00001-00 COL DIV 52169PT
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PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
j �a_y I-6 � 0 s
�g Address/(number and seven—city,state,and LIP code) — 'J -- nn - — -Sums as pmpclty'u:i,Lcs - -- -
30 '7 l� r I ' i &i n -PeLi0 \0.- Zlv 91L0 (0,
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 past 5 digits) Other(please specify in Pan 4 below)
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PART 3:CERTI ATION.
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 •
SpouijSignature Date Telephone
•
• ( )
PART 4: ADDITIONAL INFORMATION - y
[ n>t
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (R215 -92)
INSTRUCTIONS: See reverse side for tiling instructions.
111 :r : i S
_) ) CY(11.6rf certify tha P .d�of Va Gh „�
e) occupi as our principal place of residence the following described real property for which a Homestead Property Tarr WIT Rti` claime
l(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
If buying on contract, Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
•
PIJOPERTY D ION
County
Tow hi
axing dis c (ci . town, to hip)
Parcel number
����
Legal d iption
- 5 �1
If any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that stru .ure is used to produce irmme, describe the use and portion
of the property utilized to produce income. -
0
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County Township
Gounty' Township �-
1
�reby
�-
I nature of claimant '
certify the above statements are true, correct and complete.
(1)
Address and scree. dry. state, ZlPcotle) �.{ /
ss�
L �O
ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON - RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Otherland
(2)
Total land (line I plus line )
(3)
Residential improvements
Dwelling
(4)
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 pips line 7) -
(6)
1 hereby certify the above is true, correct. and
•nplele.
Signature of Assessor
Date signed
V g action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19_Pay 19_
Lesser of 1l2 Homestead
Valuation or S2,000
S -
Signature of Auditor