Homestead_Patterson CWT.Fna.M!li'10.INNI TPLA[IIAEY.FORM TS-IA
APPROVED 0151511 fiCHRD rW RYYlOTS tl,• PLE_[Wnm DV TIE oEPARMEYT(w LOCAL nlwttNMrlct M ANCE K-H.I_at
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couple.are limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than tier for homestead fraud.Homestead fraud causes higher tax hills for all:therefore.
• FIFA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they am eligible to recent the
benefit and to provide additional identifying informaanon necessary to allow county.government to better monitor homestead
filing,.This information will he kept confidential and can only be accessed by authorized county officials.The 1lepanntent of
Local Government Finance will use this information to create cools that will help county officials eliminate homestead fraud. _
.-- — - _- - ---
Taxpayer Name Property Address
Patterson, Scott D/Holly Ann
RI Box 30
Ilazleton IN 476-10
12
Scott D/Holly Ann Patterson
8099 N 50 W State Parcel Number Legal Description
Hazleton IN 47640-9214
�r�11��1tt�t��11l�tt���ttt�t�tt tt�t�ttt��r�lt��t�rt�r�t rt�t�t� 26-01-36-200-0 0.093-018 010-00093-00 PT E 36111 .70 AC
PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
• -�g AbilfeSS(nuTh&aiid street.city,state,end ZIP code) - - - -- - _El-Same as property address -- - - - -
10 99 �1 ,5—c) Gcl /7/we/e/-7<4. =A- V 76 Vc
Spouse First Middle Last
//4
�,rs�-,
Mailing Address(Number and street.city,state,and ZIP code) // Same as property address
ect el/ v !.v th 7/ r7 Z/�/ (7-7o cc,
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
PART 4:ADDITIONAL INFORMATION
•
CLAIM FOR HOMESTEAD PROPERTY TAX
'= CREDIT /STANDARD DEDUCTION
State Form 5473 (R2 15-92)
INSTRUCTIONS: See reverse side for riling instructions.
Ili „
YEAR
NVL/I I Val -
e) `F _ certify that on the 1st day of March, 1996
e) occupied as our principal place of idence the following described real property for which a Homestead Property Tax Credit is hereby claimed:
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 property or is buying under a contract.
- CONTRACT RECORDED
It 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
To 4shi
Taxing dlstripl
_fir l \
Parcel number
0 0 -'000 3
Legal
=scription
L G -� - . 70 (�
L' any portion of the residential structure or the land not exceeding one (1) arse that immediately surrounds that structure is used to produce income, describe the use and portion
of the property utilized to produce income.
Other land
(2)
60- GeD.093 -L,)4
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
Township
County
Township
®reby certify the above statements are true. correct and complete.
Signature of I
A dress lnoumberand street. city, 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)
Valuation or $2,000
Signature of A di
Other land
(2)
ned
Total land (line I 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 pits line 7)
(6)
I hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
�fying action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19_Pay 19_
-
Lesser of 1/2 Homestead -
$
Valuation or $2,000
Signature of A di
r
Date si
ned