Homestead_White (9)CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
t State Fona 5473(R5/1D-01)
,a Prescribed by the Department of Local Co eminent l inane
INSTRUCTIONS: See reverse side for filing instructions.
(We) bit_ e _ r o �. R v��Li•..y�- 4fy al 1s . Y (We) occupied as our pdndpal pl a of residence the fo 'ng descdbed real property for which a Home i S t'si`"fl1 OH I aimed
(We) owned ❑ Are buying under contrail
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.
, CO NTRACTRECORDED' ,e`r
•fe ?
�2r�_ „c,� a.k,
If buying on contract, Fee Simple owners name
T - dis
(r- wn, township)
Parcel number 1 77��
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Legal description
Is the property in question_
property ❑ Mobile Heine (I.C. 6-1.1 -7) .
Recorders office where contract is recorded
Land not exceeding 1 (one) acre immediately
Record number
Page
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.,, faP, ROPERTYOESCRIP .TION- ",�$s�.��.".a�._
County
Tamship
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(r- wn, township)
Parcel number 1 77��
C3L `_ b
Legal description
Is the property in question_
property ❑ Mobile Heine (I.C. 6-1.1 -7) .
d any portion cf D1e residentt it structure or the Land not exceeding one (1 ) ace that immediately surrounds that sUu&ure is used to prod" inmme. describe the use and portion
of the property utilized to produce income.
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County Township
County Township
I hereby certify the above statements are true, correct and complete.
Signature of claimant 1
Address (numpber aril straef, city, state, ZIP carte)
O 1 V(. t P A .1.
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AS5ESSORUSEONLY- utr =
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ASSESSEDVALUE
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"_HOMESTEAB
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'NON- RESIDENTUCL
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VACUEi�
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VALUE
..VALUE -
Land not exceeding 1 (one) acre immediately
(1)
-_
.i..p
surrounding residential improvements.
M SEE z`vsa _
Other land
l2)
`
OWN.
N.
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
A
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Residential improvements
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MO ,7.
Gana g a
(5)
y
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v
SRR
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Other improvements
(6)
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Total improvements (line 4 through line 6)
(7)
Total value (fine 3 plus line 7)
(6)
I hereby certify the above is true, Correct, and
Signature of Assessor
Date signed
complete.
Verify" action - Signature of Auditor
Date signed
WW �.- ,-r .' �=°'. v`-Ns jnk .,,STIWUARD:OEDUCTIONALL'OWAHCE
20_Pay 20_
Lesser of 1/2 Homestead
$
Valuation or $6,000
Signature of Auditor
Date signed
STATE FORM 53569(R39-10) - TREASURER FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS.2009 PRESCRIBED BY 171E DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC61.1-22-8.1
IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
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. Homestead fraud
uses higher tax bills for all; therefore, HEA 1344-2009 requires taxpayers who receive the homestead
sta dard 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 filings. This information
will be kept confidential and can only be 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.
PAR 1:'P'OP •R Y INFORMATION
Taxpayer Name Property Address State Parcel Number Legal Description:
Craie R/Debra L White 109 E VINE ST 26-04-24-304-000.421-020 COL DIV 49PT171 PTI72PT
PATOKA IN 47666
Complete and return to: — - -- -- -- - - -- - --11011MMIBIBI� fflI1 Qh illf l(��
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
PAR'P 2:TaNPA1`ER INFORMATION •
•
Owner I First Middle Last
Debra rL'nn \Nhit-e
Mailing Address(number and street.ab.state and ZIP code) I
I Same as property address
►DQ E. yiii e. at.
Last
CRai • elbcrt Ault- c •
Mailing Address(punter a street.dry,state and ZIP code)
C I Sarre as property address
.
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 1 Signature Date Telephone
LIAM t ) - S - 12 (
PART 4:ADDITIONAL INFORMATION - -.
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