Homestead_VaughtCLAIM FOR HOMESTEAD PROPERTY TAXf FORM YEAR
CREDIT /STANDARD DEDUCTION HC1D
State Form 5473 (R215 -92)
INSTRUCTIONS: See reverse side for filing instructions.
CERTIFICATION STATEMENT - r
Ie) \ V ilyithat on the 1 si day of March, 19= �
a) occupied as our principal place of resid ce the following described real property for which a Hom ead Property Tax redit is hereby claimed: `
❑ 1 (We) owned ❑ Are buying under contract !At j D• '
❑ 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
I buying on contract, Fee Simple owner's name - -
Recorder's office where contract is recorded Record number Page
PROPERTY DESCRIPTION
County
L2 5510
Township
Township
Taxing district (city, town, township)
1
Parcel number
Legal description
Address (number and streel, city, slate. ZIP code)
TN. y 7/�6
It any portion of the r idential 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.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
Township
County
Township
eby certify the above statements are true. correct and complete.
0
Signature of claimant
W �
Address (number and streel, city, slate. ZIP code)
TN. y 7/�6
Ile oe 1 19
ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
.VALUE
NON- RESIDENTIAL
VALUE -
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Other land
(2)
Total land (line I plus line 2)
(3)
Residential improvements
Dwelling
(4)
.
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 pfrs line 7)
(6)
I hereby certify the above is true, correct, and
complete.
Signature of Assessor -
Date signed
Vying attion nature of Auditor
L
Date signed
19_Pay 19_
Lesser of 112 Homestead
Valuation or $2,000
Signature of Auditor
STANDARD DEDUCTION ALLOWANCE
S
Date
MATE FORM 53,4110 fl-.P.1 TREASURER FORM TS-IA
APPR%ED BY,T1:1.BOUM Of VlttNtS.:UV PROCAID IBYmr DEPARTMENT Of LOCALnw'ERNMENT FINANCEICH.I-DR.I
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples arc limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than tier for homestead fraud.Homestead fraud causes higher tat bills for all:therefore.
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to remise the
benefit and to pnwidc additional idenufymc information necessary to allow county government to better monitor homestead
filintn.This information will he eery confide tial and can only be accessed by authorized county officials.The Department of
Local Government Finance will use this infanwtion to create tsxsis that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Vaught, Robed W Jr/Priscilla
712 S Old Patoka Rd
Patoka IN 47666
644
Robert W/Priscilla Vaught Jr Jr.
712 S Old Patoka Rd State Parcel Number Legal Description
Patoka IN 47666-9003
GIllIIlIiLIIlllIIItIlI tI II ill if IlriillnLlJliil 26r04_25400-000s56020 _o,eoosssooaTSers, ,, ,_z,AC
PART 2:TAXPAYER INFORMATION •
Owner I First Middle Last
i�° h e r r- k//` in' irl Val i g h
g Address(number anditreet,city,state,and ZIP code) — Same as property address — — - - -
Spouse First Middle Last
•
p�i'seI Ila, e e Vau1h t—
Mailing Address(Number and street,city,stale.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
•
