Homestead_Dierlam %7AT£FOAM5Mn IC!wl TREA91[LR FORMSIA
AIIRm'ED aT Va[MIMRD(i.11-0Wn.3rn rAL9(RlnmaY aIr DEPARTNOW(F LOCAE CAiLNMFAT FINA,WE ML[I"-I.1
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
,k 7 more beneficial.there is more incentive than ever for homestead fraud.Homestead fraud causes higher tax bills for all;therefore.
lit J HEA 1344-2000 and to provide ovidire axonal i who rive in the homestead M nce standard allow deduction to gorier that they arc eligible
ni monitor reecho the
�FjnJtl„ ��,1 benefit and to pnn'iJe additional identiiyin^_ infomation nem>arc to alluu'counq�government to boner mmitor homestead
a filing. Ibis information will he kepi confidential and can only be accessed by authorized county officials.The Depannxnt of
Local Government Finance will use this information to create cols that will help county officials eliminate homestead fraud.
LU10 PART 1: PROPERTY INFORMATION
APR 2 3 Taxpayer Name Property Address
Dierlam, James R/Jean A 6864/ E j 66 5
7W a of .-33s
GIBBON COUNTY AUDITOR Francisco IN 4764
8510
James R/Jean A Dierlam
6864 E 500 S State Parcel Number Legal Description
Francisco IN 47649-9157
(1u11utltllutlullrlultluntIltitltiutltllutlullnitl 26-20-05-100-000.183-001 D1�183-00 PT NW 5-3-9 43.86 AC
X
a
PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
j ar1ie5 Rus5e/ I Dien/a r-2
1g Address(number and street,city,state,and ZIP code) Same as property address — — — —_
210 f00 S Frana, 5c0, 1A/ 'I7, y9.
Spouse First Middle Last
delan Ann D/ erIarr)
Mailing Address(Number and street,city,state.and ZIP code) 1 Same as propeny address
(08G5' E 500 S franc ;scot SA) 1176 y9 U4
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.
Ow el.I Signature Date
CLAIM FOR HOMESTEAD PROPERTY TAX
El= CREDIT /STANDARD DEDUCTION
State Form 5473(R2/5 -92)
INSTRUCTIONS: See reverse side for filing instructions.
FORM YEAR
JUI 2 6 1996
1714K��1 . 2 11� • certify that on the 1 st dAUwtIrO
as our principal place of idence the following described real property for which a Homestead Property Tax Credit is hereby
`T (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 Dt9CBIPTION
County
Townsh
Taxing di nci (dry,
town, township) -
Parcel number
L sctiption
- oI?
II 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.
ASSESSED
VALUE
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
Township
County
Township -------
•eby certify the above statements are true, correct and complete.
Sig lure of claimant
Address (number and street, racy, 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)
Other land
(2)
Total land (line I plus line 2)
(3)
Residential improvements
Dwelling
(4)
-
Garage
(S)
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
II—ifying action - Signature of Auditor
Date signed
Signature of
19 —Pay 19_
Lesser of 1/2 Homestead
Valuation or S2,000
STANDARD
S