Homestead_Lamarei °3 4 CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (132 / 5 -92)
reS
INSTRUCTIONS: See reverse side for filing instructions.
CERTIFICATION
r
e) ` 2� certify dfiTA411A/�1d45tIA��� /dd�lpp
e) occupied as ou rincipal place of residence the followin described real property for which a Homestead Property TfS1I�lBtli�iSR(er y claimed:
?(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 OWNED BY CLAIMANT IN OTHER COUNTIES
PROPERTY DESCRIPTION
County
- Township
Taxing district (_city, town township)
(1)
Valuation or $2,000
Parcel number
Legal description
It 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.
�aa
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
Township I county Township
®reby certify the above statements are true, correct and complete. Signatur f claimant
Address um era street.0 /ate.DPcgjJ61
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 $2,000
Signature of Auditor
Other land
(2)
Total land (line 1 plus line 2)
(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)
(g)
1 hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
V-rifying action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19_Pay 19_
Lesser of 1/2 Homestead
5
Valuation or $2,000
Signature of Auditor
Date signed /
—/ Tb
• WiI I(ISO :94110/ -Ia 1R`AcuRtR HHL4111.\
.\PPtOVtP n\:T\lE iO1ROOr1((.IN Nfl.}.ry rruVRmED uI'11n.I11PARWEi p LOCAL GOVIZNSI TIDaMl:lr s-ti-1'-L'
Gibson County Auditor IMPORTANT-NOTICE TO HOMESTEAD PROPERTY OWNERS.'
101 N.Main Street Individuals and married couples ale limited to one homestead standard deduction.As the receipt of this deduction become,
Princeton.IN 47670 more beneficial.that is more'month,:than cvcr for homestead fmud.ilomestead fraud causes higher tax bills for all:therefore.
ItE\ 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
benefit and co provide additional identifying information and can necessary to allow county government to bcucr monitor homestead
litmus This information will be kept confidential and can only be accessed by authorized county officials.The Department of
Local Government Finance will use this information to crctte tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
MAY 7 2012 Taxpayer Name Location Address
Lamar, Hobart E/Emmillee
8892 N CUNNINGHAM RD
GOBSON COUNTY AUDITOR HAZLETON IN 47640
Hobart E/Emmillee Lamar IN I0111_DIIDIII 10111101 [001101111 _ 1110111_IUIIDOIUIi111IOU
8892 N Cunningham Rd
Hazleton IN 47640-9249
114111111111111111111111111111111111111111W11111111111111111 State Parcel Number Legal Description o
26-02-58-032-000.540-018 PT MD 32 1-1014.7405 AC
This form MUST be returned to County Auditor's office.
Please do NOT send this form back with your tax payment to the county treasurer.
-- — --_-- PARR:.TAXPAYER INFORMATION' — —_- —
a 1 First Middle Last
//abler IT 1-a/m''Qr
Mailing Address(number and street,city,state,and ZIP code) Same as property address
ggiM 4/' H17/454Q7', /42-Abfif 4626/0
Spouse First Middle Last
bml/le s Iar
Mailing Address(Number and street,city,state,and ZIP code) J // - (fit Same as property address
��90? .� (7Q/',/ 9J4Q4 4 #V2J 14
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 'igna re / Date
PART 4:ADDITIONAL INFORMATION • - - .