Homestead_Holzmeyera% CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Form 5473 (R2 / 592)
4U
INSTRUCTIONS: See reverse side for filing instructions.
FORM YEAR
HC10
I
i,
I IWe) J.A.%J..4J certify that on the' 1 st day of March -;199�q
'VYCrd,, ti claimed:
occupi d sour principal pla of residence the followin des i ed real property for which a Homestead Property Tax Credli;isLereby tlatmed:
nv rrvl.
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 properly or is buying under a contract.
CONTRACT RECORDED
It buying on contract. Fee Simple owner's name
Recorders office where contract is recorded Record number Page
PROPERTY DESCRIPTION
County Town tip Taxing di, i t (ciry. own. ; wnship) Ib
Parcel number Legal d no n
�S 1•0o R�
It any portion of the residential structure or the land not exceeding one It I acre that immediately surrounds that structure is used to produce income. describe the use and portion
of the properly utilized to produce income.
1� - 6fL�3- oa -cep. osS -o /�
ASSESSOR USE ONLY
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
Township County
Township
�reby certify the above statements are true. correct and complete. Signature of claimant
Address (number and street. city. state. ZIP code)
VALUE
ASSESSOR USE ONLY
TRUETAX
ASSESSED
HOMESTEAD
NON- RESIDENTIAL
VALUE
VALUE
VALUE
VALUE
Land not exceeding 1 (one) acre immediately
Date signed
5- io -c,S
surrounding residential improvements. I
(1)
Other land
(2)
Total land (line I plus line 2)
I (3)
Dwelling
(4)
Residential improvements
Garage
(6)
Other improvements
I (6)
Total improvements (line 4 through line 6)
I (7)
Total value (line 3 pbs line 7)
(6)
1 hereby certify the above is true. correct. and
Signature of Assessor
I Date signed
complete.
Verifying action - Signature of Auditor
Date signed
IA
I
STANDARD DEDUCTION ALLOWANCE
19_Pay 79_
Lesser of 1l2 Homestead
S
Valuation or 52.000
Signature of Auditor
D.
Date signed
5- io -c,S
STATE roKM!! •dets+m tRLASUtfl mtM Z:A
ArMrw'ED PT ST■TL dManN Mr\ai,\TS-!rn. PALV[TIarn BY 111E DEPART-NSrrw LOMALr.ovttNMENT MPAscE IC 6-1.1.22-1.1
Gibson County Auditor
101 N Main u IMPORTANT.NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead A andad deduction.As the receipt of this deduction becomes
_ more beneficial.there is more incentive than net for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
• HEA 1:44-2009 requires taspa;ers who teethe the homestead standard deduction to verily that they arc eligible to recene the
benefit and to provide additional identifvme information necessary to allow county government to better monitor homestead
filings.This information will be kept confidential and on only he accessed by authorized county officials.The Depanment 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
Holzmeyer, James/Julie
373/ Ai-2-2-5
Patoka IN 47666
439
James/Julie Holzmeyer
3731 N 225 W State Parcel Number Legal Description
Patoka IN 47666-9027
I l l t r l l l t t l l l l t n t l l l l l l l l l l l l l l l l I l l l l l l l i l l r l l l l l l l t l l 26-04-23-300-002.058-018 010-02058-00 PT W SW 23 1 11 1.00 AC
. . PART 2:TAXPAYER INFORMATION.
Owen 1 First 1 a 1 114 Middle Last
�1 � Gifcr�
.,Arm .a _ .i► Z/he.44
g Address(number end itreet.city,stele,and ZiP-ende)--' - - - i'r�1 Same as property addrms• — --- -. --
Spouse First ` ' '- Middle Last
1 l�l k 2 A pAtv� � 1Z h L2 v1z�
Mailing Address(Number and street,city.stale,and ZIP code) Same as properly addtoSJ
^� ./ ■
`PART3c CERTWFICATtON". '°-"'�.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.
Ow nature Date
PART 4: ADDITIONAIL INFOR�\1ATION
•