Homestead_Parker ....__ --�
SI\rf FOB Ott.OW wlW1 - TREASURER FOAM 73. IA
APPROVED BY MATT WOAD OF M'el".'rS.yv PEEANDED BY 211E DEPARTMENT OF LOCAL rovErsigner MA\CE IC 6-1.1-Z2-1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 bWividuaLs and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial,that is more incentive than eser for homestead fraud.Homestead fraud causes higher tax bills Cis all:therefore.
• HEA 1344-2009 requires taxpayers who reecive the homestead standard deduction to verify that they am eligible to reecho the
benefit and to provide additional identifying information necessary to allow county government to better monitor hormestcad
filings.This information will he kept confidential and ran only he accessed by authorized county olick's.The Depanntem of
Local Govenunent Finance'Till use this information to create tools that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION
Taxpayer Name Property Address
Parker, Ronald W/Lois L .
203 W 2nd
Ilazleton IN 47640
982
Ronald W/Lois L Parker
P O BOX 199 State Parcel Number Legal Description
Hazleton IN 47640-0199
I 1 I 1 1 I I 1 1 I I I I I I I 1 1 I I I I I 1 I 1 1 I I I I I I I I I 26-05-58-005-002.212-018 010-02212-00 PT MD 51 101.343 AC
1 1 111 11 1 1 11 1 11 1 1111 1 1
PART 2:TAXPAYER INFORMATION
Own r I First Middle ryry Last
••Eg Address(number and street,city,state;and ZIP code)" —
Qo QL2
Spouse t 01-.& First 2- Middle /)A r g� Last
4) C _,0,2 ilY
Mailing Address(Number and street,city,state.and ZIP code) n Same as properly address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
sate
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.
O I Signature
w e Date
( )
PART 4:ADDITIONAL INFORMATION
•
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (R215 -92)
raG
INSTRUCTIONS: See reverse side for filing instructions.
�ru M� YEAR
f HC10 ' i - ) .
JAN 2 2 1996
certify that on the 1st day of March, 19_
occupied as our principAl place of residence the following described real property for which a Homestead Property Tax Credit is hereby claimed:
LEI (We) owned ❑ Are buying under corilract
❑ 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 DESCRIPTION
County -
Township
Taxing district (city, town, township)
Parcel number
Legal description
o
Signature of dai nl
11 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.
Otherland
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
TRUE TAX
VALUE
County
Township
County
Township
eby certify the above statements are true, correct and complete.
Signature of dai nl
Address (number and street, city. state. ZIP code)
o
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
Otherland
(2)
o
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Total land (line 1 plus line 2)
(3)
Residential improvements
Dwelling
(4)
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line b)
(7)
Total value (line 3 plrs line 7)
(g)
1 hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
tying action - Signature of Auditor -
Date signed
STANDARD DEDUCTION ALLOWANCE
19_Pay 19_
Lesser of 112 Homestead
S
Valuation or $2,000
Signature of Auditor
Date signed
o
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