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Homestead_BeckyE RJR e CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT /STANDARD DEDUCTION State Form 5473 (R215 -92) reu INSTRUCTIONS: See reverse side for filing instructions. NOV 11994 \ ^\ v nnt.Hn�n arnrcmcnr (((yyy ��c �e _ �,Y• '�'' _ certify that on th�Zj h 9 7`7 I (We) occupied as our princi I place of residence the following described real property for which a Homestead Property Tax Credit is hereby claime ❑ 1 (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 If buying on contract, Fee Simple owner's name - Recorder's office where contract is recorded Record number Page I PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES PROPERTY DESCRIPTION _ - County Town hip Signature of ant Taxi di ict ry. r wn townsh Parcel number Legal d ' ti n 30 I - o It any portion of the residential structure or the land not ceeding one (11 acre that immediately surrounds that structure is used to produce income, describe the use and portion of the property utilized to produce income. (3) PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES 0ounry Township County Township I hereby can the above statements are true, correct and complete. Signature of ant Address four^ street. rlry, sf e, ZIP code) IIX� ASSESSOR USE ONLY TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON - RESIDENTIAL VALUE Land not exceeding 1 (one) acre immediately surrounding residential improvements. (1) Otherland (2) Total land (line I 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 pbs line Z) (g) 1 hereby certify the above is true, correct, and ,late. Signature of Assessor Date signed ng action - Signature of Auditor Date signed 19 _Pay 19 Lesser of 1l2 Homestead Valuation or $2,000 DEDUCTION ALLOWANCE S9 y Signature of Auditor 'Date • STATE FORM 53500(113 I 8-10) TREASURER FORM TS-1A APPROVED BY STATE BOARD OF ArmuNr&MA PRESCRIBED BY TIEDEPARTME\T Or LOCA1.001.12NMENT FINANCE IC6-1.1-12 4.1 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 fraud causes higher in bills for all;therefore, HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they am eligible to receive the Ill Y benefit and to provide additional identifying information necessary to allow county government to better monitor homestead 1 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 I: PROPERTY INFOIL\IAT ION MAY 2 2011 Taxpayer Name Location Address C. .r+` rte Beck,Thomas.J / Renee A , �C a 8627 Access 850 N GIBSON COUNTY AUDITOR 1dAZLETON IN 47640 8 Thomas JIRenee ABeck 11111UII111111II�IfI IIII�IllEllil mllBIflII_F11111_11111 IImmili11 11111 8627 Access 850 N Hazleton IN 47640-9210 , ulllllll"uilllllltlll'llli'1111'I'lll'llli' '1I111IFi111111i1F State Parcel Number -Legal Description 26-02-30-300-000.085-01 /PT LOT 4 301 101.493 AC 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. I _ PART 2: TAXPAYER INFORMATION Owne 1 , , : First Middle Last 1 hvo5 ) tuna*hors (11-ecK • Mailing Address(number and street,city,state,and ZIP cod [ame as property address 5 an N.I. Access vad an N - Spo First II Middle Last 1hen�e < An4D; icd-c �ecK — Mailing Address(Number and street,city,state.andlZIPi-Tide) - - 19"Samc es property address _ __ 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 •Id substantial fmancial penalties. Owner I Signa F; Date