Homestead_Taylor (3)CLAIM FOR HOMESTEAD PROPERTY TAX FORM v YE
CREDIT /STANDARD DEDUCTION
State Fomt 5473 (R61 4-03)
Presonbed by the Department of Loral Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
: ° --a` ERTIFICATMN STATEMENT:z
I (We) certify t of March, 20
1 (We) occupied as our principal pla of resid the following described real prop r which a Homestead Prop Yr i toRby claimed:
❑ I (We) owned ❑ Are b ng under contract
GIBSON
® Have a beneficial interest in the a tity that is liable for the property taxes o the roperty and that owns the property or is buying under a contract.
If buying on contract, Fee Simple owner's
office where contract is recorded
Record number I Page
ROP,ERTY<DESCRI ON 1 :
County '/�
Township
Taring di riot (cit , to ownship
!
1 13 %5% f7 -)
I hereby certify the above statements are We, coned and complete.
/ CJl
Parcel numbilr ��} '/
d cri tin �y s Is the pro in uesaon:
(0/V —,00 0 c/ -do
a;? Real property ❑ Mobile Home (I.C. 6-1.1 -7)
If any portion of Ne resitlentlel sWcture or them not exceeding one (1) acre that im te}y wjrounds that s cture is used to produce income. describe the use and portion
of the property utilized to produce income. �'(�
' /
�- 6 7 - -,?3 /moo -C�.
t�.a:.e ..:' ny- ..+.s.j4.- i.4PROP.ERTY.OWNEDBY CLtAIMANT -IN' OTHER` COUNTIES` c.`. 33` r7` y3I?
County
Township
HOMESTEAD,
County Township
I hereby certify the above statements are We, coned and complete.
VALUE„
Signature of U
�Wress in, ibL arJy�- treat t'>r m state ZIP=
®/ ,ter
—7:;v
ASSESSOR USE ONLY--- h
cTRUETAX x �
ASSESSEDVALUE.,
HOMESTEAD,
NONRESIDENTIAL %
_
VALUE„
_AT 100%OFiTTVyi
ti„.- VALUES'
r- VALUE.,; -si,{
Land not exceeding 1 (one) acre immediately
surrounding residential improvements
(1)
i - j-.z _, 6r1% -"
-Yz ¢'" " 'd+�i s},
A'� c
Other land
(2)
.'ham
Total land (line 7 plus line 2)
(3)
Dwelling
(4)
s r� asA•-- a�x'�'
y a...
'Residential improvements or Annually
Assessed Mobile / Manufactured Home
Garage
(5)
N
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(S)
1 hereby certify the above is We, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
F+,.r� �STANDARD.DEDUCTION'ALCOWANCE
20 _ Pay 20
Lesser of 112 Homestead
Valuation or 835.000
5
Signature of Auditor Date signed
SITE FORM 535F nt/I+0'1 MEASURER F00.M ta.:A
.A/MOVED BY%TOE BOARD Or MTT1'r•1s.4/n PEUSAIBED BY flit DEPARTMENT OF LDIat COVER-NM/ST MNANCE ICLI!L'al
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 deduction becomes •
more beneficial.there is more incentive than ter for homestead fraud.Homestead fraud causes higher its bills for all:therefore.
® HEA 1344-2009 requires tatpayers who receive the homestead standard deduction to verify that they am eligible to recent the
benefit and to provide additional identifvine information necessary to allow county government to better monitor homestead
filings.This information will be Lep confidential and can only he 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 Property Address
_ Five Star J Farms Inc
riu tt l J
AV ,\
Princeton IN 47670
2530 1 `//fib 1
Five Star J Farms Inc 1k `/
P O Box 106 State Parcel Number Legal Description
Princeton IN 47670-0106
��trt t��t� 26-04-23-100-000.850-018 010-00850-00 PT E NW 23-1-1150 AC
It irr llrrtltllrr lrrrlllrrn ll Illit tut llttlltrrt
X
PART 2: TAXPAYER INFORMATION
Owner I First Middle - Last
q0> / Al (1/2e 5 , /a5
td Address(number and steed,city,state,and ZIPP code) - - ❑ Same us property uddre ----- — - -
// 7 it/ 5(t5o /1/ 4le, yG e.
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Pan 4 below)
sox
PART 3:CERTIFICATION
Each undersigned certifies,under penalty of perjury.that the above and foregoing information is we 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.
Ow I Signature
4 Date
Spouse Signature Date Telephone
(( )
PART 4: ADDITIONAL INFORMATION