Homestead_White (7)CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Form 5473 (R5 110-01)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
I (We) certil
I (We) occupied as our principal place of residence the following described r property for which a Homestea(
❑ l(We)owned ❑ Are buying under contract
hHave a beneficial interest in the entity that is liable for the property taxes on the property and that owns the
If buying on contract. Fee Simple owners name
Recorders office where contract is recorded
FORM YEAR
HC10
Pat oblLthd-f-st day of March, 20
Property oet iMLY claimed:
I
or is
Record number I Page
'v'p M.Ili --M.
jdOE RTY. DES C RIRTIOW)?-& ;,,. —; -'Z
County
Town
I hereby certify the above statements are true, correct and complete.
Taxing district( * own, township)
WA-/ez-
et�
� T
Pa&jr-1
Legal description
eg
TRUE AX .�r
-'4LVAIL
Is - the property in question:
t71F-711 d f7--VT
V
I Qr-Real property ❑ Mobile Homo (LC. 61.1 -7)
If any portion of the residential structure or the of exceeding we (1) acre that immediately surrounds that structure is used to produce income, describe the use and portion
of the property u vtrtqg7noz�
`Township
County
Tovinship
County
I hereby certify the above statements are true, correct and complete.
Signature of claimant
'idress (number and street, city, state, ZIP code)
r ASSES�.SOR SE NO ,-
M -&V
TRUE AX .�r
-'4LVAIL
A
ASSESSED
-!ATA1
XmOMESTEAD��'
NON-RESIDENTIAL,
00%-OF.TrV1
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
-M
Other land
(2)
-V
^6 ,Ohl Ohl —IlM
V
Total land (line I plus line 2)
(3)
WMM
Dwelling
(4)
I Mai
i
Residential improvements
Garage
(5)
4Y lzy-P-i5
w
g"Loj
Other improvements
(6)
Total improvements (fine 4 through line 6)
(7)
Total value (line 3 plus line 7)
(8)
I hereby certify the above is true, correct, an
Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
20 _ Pay 20 _
Lesser of 1/2 Homestead
S
Date signed
X-- Ye—o I,-
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RATE FORM!TIA IR/NYI 1RE sI:W CORM 73-IA
APPMl'EO BY'4ATE BOARD OF A(TT,ENT'.n N PRr9r 1DW BY TIE DEPARMENtOf LOCAL CMERNMrsaT EB:ASCEMVI.I-L--4.1
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 premise than ever for homestead fraud homestead fraud causes higher tax bills lix all:therefore.
• HEA 1344-200W requires taxpayers who receive the homestead standard deduction to verify that they am eligible to remise the
benefit and to provide additional identifying information neces ry to allow county government to better monitor homestead
filing.This information will he kept confidential and can only be accessed by authorized county officials.The Depanntem of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION
Taxpayer Name Property Address
White, John D JR/Jenny E
RI
PATOKA IN 47666 \O
625
John D White Jr.
109 W Bluejay St State Parcel Number Lesal Description
PATOKA IN 47666-9083
�t�t t��att�t��ttt��ttt lltTll'Itlltt t�tt ll ttljlllttt�t�tttt�t�� 26-04-25-300-000.587-020 018-00587-00 PT SW 251111.974 AC C-1
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
e Address(number end>rreet,city,state,/rid code) SBUte us prom:fly idles -— —- ---- —— -
�� ;h L ), IAL e_Tc- - Pa-t a a_N 41 6cQ(0
Spouse First Middle Last
Can f LOP, (-Fe
Mailing Address(Num and street,city,state,and ZIP code) r ..Snore as property address
1oII <Y 51 l � z'1o•1y7(12 tin la
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
PART 4:ADDITIONAL INFORMATION
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