HomeMy WebLinkAboutHomestead_GrossCLAIM FOR HOMESTEAD PROPERTY TAX
e CREDIT /STANDARD DEDUCTION
State Form 5473 (R2 15-92)
rsie
INSTRUCTIONS: See reverse side for filing instructions.
FORM YEAR
HC10
l ^Ne) l- � - - certify that on tfie` I'st'i Ny-bI' 1aFCh; 99
�) oc ed as our principal place of residence t ollowing described real property for which a Homestead Propertvf3�R�rlit1� IMetB claimed:
❑ I (We) owned ❑ Are buying under contract - / ,,ff�sllFM1 KKlI �WJJJUU
❑ Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the pro42� %,e ii yu 4&g ug0gr 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
County
Taxing district (city, town, township)
Parcel number
O o
.Legal description {nom
—
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.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
Township
County
Township
® eby certify the above statements are true, correct and complete.
Signature of claimant
Address (number and street, city, state, ZIP code)
P
ASSESSOR USE ONLY
TRUETAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON- RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Valuation or $2,000
Signature of Aurito- O
Other land
(2)
Total land (line I plus line 2)
(3)
Residential improvements
Dwelling
(4)
-
i
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(6)
1 hereby certify the above is true. correct. and
complete.
Signature of Assessor
Date signed
Verifying action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19 Pay 19_
Lesser of 1/2 Homestead
S
Valuation or $2,000
Signature of Aurito- O
Date signed
AF?RI EDB STATE R ( TYIWSCT IC 64.1-1:41
APPROVED BT'RVE&rVtU(M'nrcMiMt.:✓n PAIV(WpEnpY file aFYMTW]frOF LOCAL C9 @RVMrLT FINANCE IC H.I-S]J.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 deduction becomes
more beneficial,there is more incentive than ner for homestead fraud.Homestead fraud causes higher tax bills for all;therefore.
® HEA 1344-2000 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to recene the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will he 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 INFORMATION
Taxpayer Name Property Address , /
Gross, John E/Kathy S aZt-i a Jv
' LA
Patoka IN 47666
429
John E/Kathy S Gross
2242 W 400 N
Patoka IN 47666-9029 State Parcel Number Legal Description
tlttlltttlti 47666-9029
illillllllill�tilil�r� 26-04-23-100-000.980-018 010-00980.00 PT S NW 23-1-111.575 AC
r
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
reNINN 6b WA R° GRoss
0 tg eAadn¢s(number and strLCi,etty,state,and ZIP yodel-__ _ __ _ __ __ -_ _ 0-Sarin as property address-- -- -_._ — _ ___._
lEgkRa aata w 400 NI -PRRMeKP 1n y-1i.la G
Spouse First Middle Last
KINTa/ Su t Ggos-s
Mailing Address(Number and street,city,state,and ZIl'code) ❑ Same as property address
Gaya Znl 400 4 f h-r-0 k A i T1,) L76, lp G
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.
Owner I Signature �w -- n Date
PART 4:ADDITIONAL INFORMATION
• � t '� ; /.
APR ^ELUlL'
17, ,e4
L/
=SON COUNTY AUDI'CP