Homestead_Phillips SLATE 10101 53,0•01.2 IWO fRFASLEFA PORN 73-IA
.ArPROVED BY STSTE BnVNOEArrf*l9s.9m rRISIMBm BY Tr1E DEPARTMENT OF LtX I GoVEL'MrTT FIK%CE Mi-144:41
Gibson County Auditor
101 N Main . IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead sandani deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than ever for homestead fraud.homestead fraud causes higher In bills for all;thereat.
HIM 13-14-3009 requires taspayer>mho receive the homestead standard deduction to verify that they am eligible to reecho the
benefit and to provide additional idenlifyitn information necessary to allow county gmemment to better monitor homestead
filings.This information will he kept eonlidential and can only be accessed by authorized county officials.The Department of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
/� Phillip- Carole Davis
L, 6130 N50E
_V Hazleton IN 47640
987 (
Carole Davis Phillips \ A'l/
6130 N 50 E `e\C
Hazleton IN 47640-9240 _ State Parcel Number Legal Description
Illrtllttrlllltttlttllltttllltttrlllllrrlll IIIII III 26-05-58-022-000.692-018 010-00692-00 PT MD 22 1-10 2 AC
Spouse First hliddly 2i2`/ Lust
Mailing Address(Number and street,city,stale,and ZIP code) [.Same as property address
030, N <0 F k v(9°
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
•
a
CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDIT /STANDARD DEDUCTION HC10
State Form 5473 (R2/1 -90)
INSTRUCTIONS: See reverse side for filing instructions.
L
CERTIFICATION STATEMENT
I (
�,, ��___,,CaAeacertify that on the 1st day of March, 19
��We) occupied as our principal place of rest ence thehff Ilowing described real property for which a Homestead
rope �� Ire�j b�} by claimed: ` .LJ 1 (We) owned ' (] Are buying under contract
atb�!ri®fir§idl by
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 buyigtpr t ftt, a Owner's Name
_ AUDITOR
Recorder's office where contract is recorded Record Number • • Page
PROPERTY DESCRIPTION,
County Township Taxing District (City, town, township)
PAT umber Legal Description _ I _ I O 109a, co 1 a.
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.
PROPERTY OWNED BY CLAIMANT'IN OTHER COUNTIES
County
Township
County
Township
iereby certify the above statements are true, correct and
Signature
.,omplete. _ I - -
_
Address (Street, number, city, state and 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
Other land
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)
"
(1)
1991 Pay 1992
19 — Pay 19 —
Lesser of 1/2 Homestead
(2)
Lesser of 112 Homestead
Lesser of 112 Homestead
Valuation or $2,500
(3)
Valuation or $1,500
Valuation or $1,500
(4)
Signature of Auditor
(5)
S-
(6)
(7)
(8)
I 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 1/2 Homestead
Lesser of 1/2 Homestead
Lesser of 112 Homestead
Lesser of 112 Homestead
Valuation or $2,500
Valuation or $2,000
Valuation or $1,500
Valuation or $1,500
Signature of Auditor
Date Signed
S-