Homestead_Anthis (3)CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
:. State Form 5a73 1R2 / 5-92)
eie
INSTRUCTIONS: See reverse side for filino instructions
FILI O YEAR
70
SEEP 24
/ V r \ _ / Y\.1J`Na' certify that on the 1st day of March, 19_
as our principal place of residence the following described real property for which a Homestead Property Tax Credit is hereby claimed:
T (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 -
Recorder's office where contract is recorded Record number Page
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
PROPERTY DESCRIPTION
County
Township
Taxing dish (city, (con, r nshi
Parce' umb r
o M1 -0
Legal description
-4107 ax—
O
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.
Other land
uc
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
Township
County
Townstup
e y certify the above statements are true, correct and complete.
Signature of claimant
Address (number and street, city, state, ZIP code)
ra
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
Signature of Au r
Other land
(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 pfrs line 7)
(g)
I hereby certify the above is true. correct. and
complete.
Signature of Assessor
(Date signed
Verifying action - Signature of Auditor
I Date signed
i�
STANDARD DEDUCTION ALLOWANCE
19_Pay 19_
-
Lesser of 1/2 Homestead
S
Valuation or $2,000
Signature of Au r
Daled ^ x / ^
Off/ /7/ Y.3
•• 4 - STATE FORM S1504(NJ 1e-10) TRFASLIIFA FORM TATA
^. APPEAED BY STATE BOARD OF ACCOUNTS.X0T PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC 6-1.1124.1
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N. Main Street Individuals and married couples are limited to one homestead standard deduction. As the receipt of this deduction becomes
Princeton, IN 47670 more beneficial,there is more incentive than ever for homestead fraud.Homestead Gaud causes higher tax bills for all;therefore,
HEA 1344-2009 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 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.
PART 1: PROPERTY INFORMATION
Taxpayer Name Location Address
_ Anthis, John B
0
PATOKA IN 47666
1734- 1 1II
John BAnthis II.IDIIIIDII�III11 iIII_I fllIIDII_I_III��IIIII_II.IIItlI_II.I�IDIID�IIDIIIIII VIII
621 E Steelman RD
Patoka IN 47666-9104
rtlllllllll)Irl)IttIIillli iIII'IIIII'lIi""IIIII' III'I"I'IIIII State Parcel Number Legal Description
26-05-58-023-000.020-018 /PT MD 231-10 70.6419 AC
FILED
APR 2, 5 2011
C.,.
This form MUST be returned to Court or's office.
COON
Please do NOT send this form back with iiiiirtax payment to the county treasurer.
.r.. 1 First Middle) -
Last
V O L„ + 3 / „ v _
Mailing Address(number and street,city,state,and ZIP code) nn nn p n Same as property address
b3I '� Seem Imo' 1 4--lob to
First Middle L
Last
A A fiS
Mailing Address(Number and street,city,state,and ZIP code) Rename as property address
loa l g s4-egAvvtc o 2i , ?a-17)10L t3 4-i i,
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 l I
PART 4: ADDITIONAL INFORMATION