Homestead_Evansfyf {f'f r!
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
V State Form 5473 (R2 / 5 -92)
INSTRUCTIONS: See reverse side for filing instructions.
IN �' r
I.
m 31996
_V4 �� L4�1ti7••° / V t L/L,C.R/YV certify that on the AA�b'��{cX, 19
occupied as our principal place of residence the following described real property for which a Homestead Property Tax Credit is hereby claimed:
❑ I (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
PROPERTY DESCRIPTION
County
Township
Taxing district (city town, township) .
Parcel number
Legal description
Signatur I claimant
Address (number and street, city state. ZIP code)
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.
�C- 03- d3 -3QO- 6�0.74� =ar �
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
Township
County
Township
geby certify the above statements are true, correct and complete.
Signatur I claimant
Address (number and street, city state. 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.
(1)
Valuation or 52.000
Signature of Auditor
Other land
(2)
S -
Total land (line I plus line Z)
(3)
Residential improvements
Dwelling
(4)
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plrs line 7) -
(6)
1 hereby certify the above is true. correct, and
complete.
Signature of Assessor
Date signed
r9 action - Signature of Auditor
L®
Date signed
STANDARD DEDUCTION ALLOWANCE
19_Pay 19_
Lesser of 1/2 Homestead
S
Valuation or 52.000
Signature of Auditor
Date signed
Ok
S -
FMI
s
MAIL FORM!!H IR_I YNI TREAST:tQ FORM 75-1A
APPROVED By sr■u MO Of MYTR'ST'.Zino PREYIUBED BY ME DEMME:470r LOCAL GOVERNMrr.T FINA\LSMFI.t_I.I
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead standard deduction.As the receipt of this dedunion becomes
more beneficial.there is more incentive than ever 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 receive the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will be Lepo confidential and can only be accessed by authorized county officials.The Ikpannumt of
Local Government Finance will use this information to create tools that will help county otTtdaLs eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Evans,Arthur R/Rita M
P O Box 349
Patoka IN 47666
290
Arthur R/Rita M Evans
P O Box 349 • State Parcel Number Legal Description
Patoka IN 47666-0349
26-03-23-300-000.795-018 010-00795-00 PT S FR 23-1-12.567 AC
• PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
tg Addre s(number and stem,city;stare,and ZIP code) e — -- ' —. Same as pory pe oddness -— -- - — —
`bi�`61,o Lv l 4' yv r-\Loscca
Spouse First Middle Last
_
Mailing Address(Number and street.city,state.and ZIP code) Same as property address
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 S f� //�� Date
PART 4:ADDITIONAL INFORMATION
•