Homestead_Buck (3)I ' STATE FORw535t.IR-I SAND TRE491ln IORV i3-1A
AFITINED
TO HOMESTEAD PROPERTY OWNERS
6-1.1-r-1.1�
a Gibson County Auditor
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 Homestead fraud causes higher tax bills for all:therefore.
/ HEA 1 344-3009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
benefit and to provide additional identifying information necessary to allow county gaemment to better monitor homestead
lilings.This information will he kepi 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.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address •
Buck, Mercella/Bradley R
P O Box 75
Mackey IN 47654
3292
Marcella/Bradley Buck
4e R2 Box 202 B State Parcel Number Legal Description
ELBERFELDIN 47613
26-20-21-400-000.098-001 001-00098-00 PT SW SE 21-3-911.99 AC
D-8
_.._ - ____ ._..... ___ ___ _. _. _— — _ _— _—_
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
g OwwnDer I Firs Last
First Middle Middle
Slag Address(number and street,city,state.and ZIP code) Same as property address Q V_ 5-7.5 .9
Or 3cK7S /17ackevZ JdiAu� s47 `sf qii etdIFeccgf3f c15�
Spouse First Middle Last
aga�_, A.a:�ccOa,uicos.- .
Mailing Address(Number and street,city.state,and ZIP code) ❑ Same as property address
Social Security Number(last 5 digits) I Driver's License/State ID Number (last 5 digits) Other(please specify in Pan 4 below)
_ .._ See
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
• VI lilt\
9 // ? 5" 711 S. 51Sa
• £ / herrelay. f/,)d 1' #i A.44
4/'76 i3
CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
i; CREDIT /STANDARD DEDUCTION HC10 cl
State Form 5473 (R2 15.92)
rs8
INSTRUCTIONS: See reverse side for filing instructions. -
_) I 0 1 l�..l„ CQ J( V Z, - V-J-C,k4 �A - certify th on the I stld�ay March, 19 1 l
,a) occupied as our principal place of residence the following described real property for which a Homestead 44w"a adit aimed:
4
El AUDITO I (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
It buying on contract, Fee Simple owner's name -
Recorders office where contract is recorded Record number Page
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES ,
PROPERTY DESCRIPTION
County
Township
Taxing district (city, town, township) -
Parcel number
Legal description
Address (number and street. city, state. ZIP rode)
�-y�
oO -`l.
"
It any portion of the residential 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.
Total land (line 1 plus line 2)
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES ,
County Township
County Township
Wreby
Signat re f clai t
certify the above statements are true, correct and complete.
n
C .
Address (number and street. city, state. ZIP rode)
ASSESSOR USE ONLY
TRUE TAX
..VALUE
ASSESSED'
VALUE
HOMESTEAD
VALUE
NON- RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Valuation or $2,000
"
Otherland
(2)
Total land (line 1 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 pits line 7)
(6)
1 hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
ig action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19_Pay 19_
Lesser of 1/2 Homestead
$
Valuation or $2,000
Signature of Auditor
rl�
Date sig3ned
- - 9
- -- ---<. - f i