Homestead_BrandebourgCLAIM FOR HOMESTEAD PROPERTY TAX rnol EAR
CREDIT /STANDARD DEDUCTION-
State Form 5473 (R2/1 -90) Rj
INSTRUCTIONS: See reverse side for tiling instructions. 1 1992
FEB 2
CERTIFICATION STATEMENT
wi.. — •_
W
I (We) w k certify that on the 1 st day of g °I �
(We) occupied as our principal place of residence the following described real property for which a Homestead
Property Tax Credit is hereby claimed: L2-T—(We) owned ❑ Are buying under contract
El -property a beneficial interest in the entity that is liable for the property taxes on the property and that owns the
property or is buying it under a contract. • f'
CONTRACT RECORDED
If buying on contract. Fee le le Owner's Name
_ CM n!La9 -bOb - Oef�.lbl -Z�l
Recorder's office where ontract is recorded Record Number Page
PROPERTY DESCRIPTION
tip, Taxing PiptriFt City town,
Legal
v1v - • w %o 1 - I v t I cr
If any portion of the residential structure or the land not exceeding one (1) acre.that immediately surrounds that struc-
ture is used to produce income describe the use and portion of the property utilized to produce income.
1530 -130 )RDO 3
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County I M yr� 9t e.Iownship I County I Iown
1
—.hereby certify the above statements are true. correct and 51g ture
complete. 16 1
Address (Street, number, city. state and ZIP code)
ASSESSOR USE ONLY TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON -RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements
Other land
Total land - line (1) plus line (2)
Residential improvements Dwelling
Garage
Other improvements
Total improvements - line (4) through line (6)
Total value - line (3) plus line (7)
(1)
1991 Pay 1992
19 —Pay 19—
Lesser of 112 Homestead
(2)
Lesser of 112 Homestead
Lesser of 1/2 Homestead
Valuation or $2,500
(3) r
Valuation or $1,500
Valuation or $1,500
(4)
Signature of Auditor
(;1) -M,,
(5)
Date Signed
:�_,1j -1
(6)
(7)
(8)
1 hereby certify the above is true,
correct, and complete
Signature of Assesor
Date Signed
Verifying Action - Signature of Auditor
Date Signed
STANDARD DEDUCTION ALLOWANCE
1989 Pay 1990
1990 Pay 1991
1991 Pay 1992
19 —Pay 19—
Lesser of 112 Homestead
Lesser of 112 Homestead
Lesser of 112 Homestead
Lesser of 1/2 Homestead
Valuation or $2,500
Valuation or $2,000
Valuation or $1,500
Valuation or $1,500
Signature of Auditor
(;1) -M,,
Date Signed
:�_,1j -1
(1
STATE FORM 53569(R23-09) TREASURER FORM TS-IAI
APPROVED BY STATE BOARD OF ACCOUNTS.2009 PRESCRIBED BY ME DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC611 22-5.1
IMPORTANT NOTICE TO HOMESTEAD PROPERTYsOWNERS ' ,
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
Sauses higher tax bills for all; therefore, HEA 1344-2099 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. • • •
PAR 1: PROPER 'INFO'MA ION
Taapaver Name Property Address L, State Parcel Number Len)Description:
Douglas/Robynee �o1 z' $$ N U$ l 1 26-05-58-006-000.161-018 010-00161-00 PT MD 6-I-10 4 AC
Brandebourg Pa oka3N'4T6b6 i-1 a z-i e.t o IA \L
Complete and return to: ®�
GIBSON COUNTYAUDITOR, 101 N MALN PRINCETON IN 47670 -
PART 2: TAXPAYER INFORMATION
Owner 1 First Middle last
. baDc. G4_AS KE/ rH QRAy 1 DEeou 2.0
MaBng Address(number and street_city.state and ZIP code)
Same as property address
l 014 8g AJ. u,3 Nwl tJl NAZLE-O,,J 114 q7( q
/ he _ Last
20(3v/.lti[E V i �.t- //At C5 • gQA,JDC (310c.12C
Magog Address(number and street city.state and ZIP code) Same as properly address
609 g g id. 0_6- /kJ y V/ //A Z L Ero,-1, lit! 4-76,-.4)
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-
• ner gramre Date
•rll - - (" 1 PART 4: ADDITIONAL INFORMATION -
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