Homestead_Mountsc�i
�• °� CLAIM FOR HOMESTEAD PROPERTY AX
a% ae FORM
- ; CREDIT /STANDARD DEDUCTION HC10
State Form 5473 (R2/1 -90)
INSTRUCTIONS: See reverse side for filing instructions.
CERTIFICATION STATEMENT
I (We) certify that on the 1 st day of March , 19 9�
/We) occupied as our principal place of residence the following described real property for which a Homestead
Property Tax Credit is hereby claimed: Ej--q Ve) owned I] 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
El property or- is buying it 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 DESCRIPTION
County
Town
Taxi
i
r' t ( it , to , township)
Parcel Number 39
Legal
riptip W i 10
JJ S oo
If any portion of the residential structure or the land'not exceeding one (1) acre that immediately surrounds that struc:.
ture is used to produce income describe.the use and portion of the property utilized to produce income.
�� -�� /5L �o- oao. X39- 0�2- -- •
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
(4) _
County
Township
County
Township AV innn
hereby certify the above statements are true. l correct and
Sign ure - -
complete. - _ ' '
y-
Address (Street, number. city. state and ZIP code)
AUDITOR
ASSESSOR USE ONLY - •TRUE TAX VALUE ' ASSESSED VALUE HOMESTEAD VALUE NON - RESIDENTIAL
VALUE
Land not exceeding 1. (one) acre immediately'.
surrounding residential improvements
Otherland
Total land - line (1) plus line (2)
Residential improvements Dwelling. ,
Garage
Other improvements
Total improvements - line (4) through line (6)
Total value - line (3) plus line (7)
11)
1991 Pay 1992
19— Pay 19—
Lesser of 112 Homestead
(2) -
Lesser of 112 Homestead
Lesser of 1/2 Homestead
Valuation or $2,500
(3)
Valuation or $1,500
Valuation or $1,500
(4) _
Signature of Audi
fJ .
(5)
(6)
(7)
(8)
1 hereby certify the above is true,
correct, and complete
Signature of Assesor
Date Signed
Verifying Action - Signature of Auditor
Date Signed
STANDARD DEDUCTION ALLOWANCE
1989 Pay 1990
1990 Pay 1991
1991 Pay 1992
19— Pay 19—
Lesser of 112 Homestead
Lesser of 1/2 Homestead
Lesser of 112 Homestead
Lesser of 1/2 Homestead
Valuation or $2,500
Valuation or $2,000
Valuation or $1,500
Valuation or $1,500
Signature of Audi
fJ .
Date Signed
S-7-To
Q
'ATE FORM!nt.IRu W•1 ntrAsuararoastraiZ
AnFliv'ED BY SI ATE Bt WD OF.YrVILTS.`nn PRattBm BY 11W OEPMTNEAT OF LOCAL GOVEANMIwr FINANCE tell1.1-_J.I •
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N Main `
PRINCETON IN 47670 Individuals and married couples are limited to one homestead 9andani deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than ever for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
• HEA l344-2009 requires taxpasem who receive the homestead standard deduction to verify that they are eligible to precise the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will be kept conlidcntial and can only be accessed by authorized county officials.The Depann ent of
Local Government Finance will me this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Mounts, Virgil/ Evelyn 1 gD1)
__II
. old. Rd Box 450/)0YI5
Patoka[N 47666
396 //J I
Virgil/Evelyn Mounts V ' I UI//
2110 W 450 N State Parcel Number Legal Description (11���'
Patoka IN 47666-9037
26-04-14-400-000.639-018 010-00639-00 PT SW SE 14-1-11 10 AC
lil,il lies tlt lliui ll•ttlItt ltltt lliiu iul lulp.il uuell ll Ill
PART 2:TAXPAYER INFORMATION
Owner I,Y/ e / First Middle Last
• 1 , 'L / °—P /Vin !rte AI-PS
•tg Address(number end street.city,state,and ZIP code) - —"- --" — -- ' 0-Same ua propcny oddrcss --- — --
0,//O vs-i 1 Al So is)
Spouse First Middle Last
ve—Ly 3 4AlAl MOct., AJ + S
Mailing Address(Nu r and street.city,sole,and"LID'code) ❑ Same as property address
c2j/o \ir I/573 , -
•
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 Date