Homestead_Cleveland San rn0.M.!9/01:r.-1.0 EAESSUMER RAW"3-IA
APPROVED IMPORTANT NOTICE TO HOMESTEADEP PROPERTY OWNERS t
. Gibson County Auditor
101 N Main
PRINCETON IN 47670 IndividuaLs and married couple arc limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than es er for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
• HEA 1541-2IX9 requires taxpayer who receive the homestead standard deduction to verity that they are eligible to teethe the
benefit and to provide additional identifyine information necessary to allow county government to better monitor homestead
lilimet This information will he kept conlitl ntial and can only he accessed by authorized county officials.The Department of
Local Government Finance will um this information to create tests that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Cleveland, Ginger E
I22 Box 270
Buckskin IN 47647
8758
Ginger E Cleveland
8492E 900 S State Parcel Number Legal Description
Buckskin IN 47647-9001
!tWtt��ttt�t��t tt�tt��ttt��t�tt��rtt��trtttt���t�t ttt�t�ttr��� 26-20-27-100-000.054-001 PT NW 27-392.155 AC D-19
PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
(.7ln-)ler gInhoe Cif(Ie /8'JD
t g Address(number and street city,state,and ZIP code) — _- _Id Same as nc seity address _ _
$Lf 9," E goo S 31,0(516A/ 474y-7
Spouse First Middle Last
Mailing Address(Number and street,city,state.:and ZIP code) ❑ Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Pan 4 below)
•
sat
PART 3:CERTIFICATION
Each undersigned certifies,under penalty of perjury,that the above and foregoing information is true and correct and that he or she is eligible to
receive the homestead standard deduction on this property. Each undersigned also understands that,by claiming additional homestead deductions
unlawfully,he or she may be liable for back taxes and substantial financial penalties.
Ovine I Signature Date
•
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
Slate Form 5473 (R6 / /-03)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing insimctions.
I (We)
certify
I (Wfe) occu led as our print al place of residence the following desuibed real property for which a Homestead
ikI (We) owned ❑ Are buying under contract
Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the p
If buying on contract, Fee Simple owners name
Recorders office where contract is recorded
FORM- -- -_ YEAR
HC10
of
0EC 15 1003
or is buying under a contract.
Record number I Page
z= �Axs`-4ra ?ROP.ERTY,OWNED`;Bl' CI'AIMANT;IN,'OTHER`COUNTIES;i' ,.$- ,..:?� °''1a`-'.% =e!s•.'"ts #.`tS
County
Township
County
Township
Taring d
to
unship)
c( \u r
V _ O 0
Legal description
1
Is the property in quesfion:
1 -0-R'€al property ❑ Mobile Homo (I.C. 61.1-7)
If 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.
aL - 010 -(4,7- lbe -GYRO. -oo
z= �Axs`-4ra ?ROP.ERTY,OWNED`;Bl' CI'AIMANT;IN,'OTHER`COUNTIES;i' ,.$- ,..:?� °''1a`-'.% =e!s•.'"ts #.`tS
County
Township
County Township-
I hereby certify the above statements are We, correct and complete.
Sign of claimant
Address (n tuber and street, city, state, ZIP code
,, 'ASSESSOR USEON Y
UErY
AT 700Ye OFiTTVHOVALUE�D
.c�- sue...,... ..-.r
P NONESIDENTIA�L;¢y(:.v
...VALUE.tt. "i,`a
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
Other land
(2)�,.'E
<riEfta -'-�4
Total land (line 1 plus line 2)
(3)
Residential Improvements or Annually
Assessed Mobile I Manufactured Home
Dwelling
Gara ge
(4)
�Qpte^,gr;
Other improvements
(6)
Total improvements (line 4 through line 6)
(T)
Total value (line 3 plus line 7)
(6)
hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
Verifying action - Signature of Auditor
Date signed
Signature of Auditor
20 _ Pay 20 _
Lesser of 1/2 Homestead
vauatton or 535.000
5