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CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDIT /STANDARD DEDUCTION HSff
'
State Form 5473 (R2/1 -90) '
INSTRUCTIONS: See reverse side -for filing instruction
CERTIFICATION STATEMENT
.860a.. ?o)3(
that on the 1 st day
�(We) occupied as our principal place of resid6nce the following described real property for which a Homestead
Property Tax Credit is hereby claimed: L[;-.14We) owned ❑ Are buying under contract
Have a beneficial interest in the entity that is liable for the p o�perty taxes on the property and that owns the
property or is buying it under'a contract.,
CONTRACT RECORDED-
It buying on contract. Fee Simple
Recorder's office where contract is recorded - I Hecord Number . I Page
DESC
v
township)
1 Parcel Numberoio- 00/2a -o Legal Description I
SIC q I I I /6O.co A c�-
If any portion of the residential structure.or the land not exceeding a (1) acre that immediately surrounds that struc-
ture.is used to produce income describe the use and.portion of th property utilized to produce income.
PROPERTY OWNED BY CLAMANT IN OTHER COUNTIES
County Township County Township
I
7 hereby certify the above statements are true, correct and Signature -
complete. - -
Address (Street, number, city. stAte and ZIP code)
7
ASSESSOR USE ONLY _ TRUE TA VALUE ASSEESSE 1- tlFfiO ALUE N•REALIUE�AL
Land not exceeding 1 (one) acre immediately
surrounding residential improvements
Otherland
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)
-
f1)
1991 Pay 1992
19— Pay 19—
Lesser of 112 Homestead
Lesser of 112 Homestead
(2)
Lesser of 112 Homestead
Valuation or $2,500
Valuation or $2.000
Valuation or $1,500
Valuation or $1,500
(3)
Signature of Auditor
Date Signed
4
(4) - - -
-
-
-
(5)
_
(6)
0 Jj
�ItJ�
(7)
(8)
I 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 112 Homestead
Valuation or $2,500
Valuation or $2.000
Valuation or $1,500
Valuation or $1,500
Signature of Auditor
Date Signed
4
A
- - • SlAtE IMAM!!!....R2/t.o TREASURER FORM fl-1A
APPROEDPY MATE w, onF AC-MINTS_ ,• PRESCRIBED DY TIM DEPARTEMTFLOCAL rnVER.yMrI<r FINANCE re L1.1-L•4.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to nne homestead standard deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than ner for homestead fraud Homestead fraud 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 receise the
benefit and to provide additional identifyinc infornanon necessary to allow county government to better monitor homestead
filings.'this information will be Lep,confidential and can only he accessed by authorized roomy officials_The Department of
Local Government Finance will use this information to create uzzls that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Bugher, William C Life Est Trust
Cunningham Ferry Road
Patoka IN 47666
1538
William C Bugher Life Est
R1 Box 47 A State Parcel Number Legal Description
Patoka IN 47666-9040
nn��ntr��r r�r�n n��nn rn�rn���nr n�n�nrr��nn nr��n� 26-04-14-200-0119.175-018 010-00175-00 PT E 14-1-11171.50 AC
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ff5 an 0 4,-0y _it/ -zoo 03,2950—CY8'
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
Oie cow b,
ig Address(ntim6cf and street:city,State,nand Z PFodc) — - - ---- — ' — /Same as pro ivy addn ,
— 4edr -D (U zed w f LLt 4)666
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) ❑Same as property address
Social Security Number(last 5 digits) Drivers License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
sits
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
unlaufidly,he or she may be liable for back taxes and substantial financial penalties.
Owner)Si stare Date
Spouse Signature Date Telephone
)
PART 4:ADDITIONAL INFORMATION
•