Homestead_Schwartzlosedd i CLAIM FOR HOMESTEAD PROPERTY TAX
s' CREDIT /STANDARD DEDUCTION
.` State Form 5473 (R2 15-92)
ws
INSTRUCTIONS: See reverse side for filing instructions.
FOR YEAR
10
MAY 0 6 i99tl
CERTIFICATION STATEMENT
I(We) /� C(�GcJ l iJSE (fftHafo t eA s�dyA ?� .ls
wt .
jVe) occupied as our pr' cipal place of residence the fol "ng described real property. for which a Homestead Progeny 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
L
-. ASSESSOR USE ONLY
- PROPERTY DESCRIPTION
County
Township
Township
Taxing d' ct ( try to• n, tow
Parcel number
C/-,
Legal descripti
te a tr correct and complete.
D= v.
,Address (number and street. city, state, hP cede
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.
Total land (line 1 plus line 2)
(3)
L
-. ASSESSOR USE ONLY
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
HOMESTEAD
VALUE
Township
County
Township
•e rti y t e e
te a tr correct and complete.
Signature of claimant
,Address (number and street. city, state, hP cede
(2)
L
-. ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON -RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Signature of or
Da'?-no:,
Otherland
(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 pits line 7)
(6)
I hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
Verifying action - Signature of Auditor
i
Date signed
6•A
° STANDARD DEDUCTION ALLOWANCE
19_Pay 19_
Lesser of 1/2 Homestead
Valuation or $2,000
$
Signature of or
Da'?-no:,
ctArE gRa si!NA:04Nt IXSACURYI MILM ISIA
APPRovEoa\H\IE 3MRnorurI K;s4 ,RICPJBEOtt'n4.DVARIMEMO lOcALCOITxCWSI,LR`FCIrN.I"dl
Gibson County Auditor •• IMPORTANT NOTICE TO.HOMESTEAD PROPERTY'OWNERS'
101 N. Main Street Individuals and maned couples are limited to one honk-et-ad standard deduction.As ate receipt of this deduction becomes
Princeton, IN 47670 more beneficial,then is more inventive than ewer for homst• d fraud.Homestead fraud caums higher tax bill>for all:therefore.
• HEA 1344-200n requires taxpayers who receive the homestead slandarJ deduction to verify that they are eligible to[grebe the
benefit and to preside additional identifying information necessary to allow cony' government to better monitor homestead
filing>.Thi information will be kepi confidential and can only be accessed by authorized county officials.The Depanmem of
. t.m mtn Finance will use this information to create tools that will help count'officials eliminate homestead Baud.
F IL PART 1: PROPERTY INFORMATIONt-•
Taxpayer Name Location Address
2��2 Schwartzlose, Gary C Life Est Etal
JUN 2 5 OFF CR 350 N
—
C-').t✓ PATOKA IN 47666
677 ��GG
9chwartzlose(;aiySDN COUNTY AUDITOR 11111111011 III 0llIfillIIIII llIF il ""-IF III mmm111111E110111111 Q11 11
3119 N 150 W
PATOKA IN 47666-9021
IIIIIIIIIIIIIIIIIIII111111IIII11IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII State Parcel Number Legal Description
26-04-26-200-001.864-018 PT SW NE 261 11 3.253 AC C-1
0
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-
. , I .4 r r,•
-— s I First Middle l Last
C A� Sly CLI -V ov n Sc kw-ArT 2 LoSe
Mailing Address(nbnber and street,city,stare-and ZIP code) 0 Same as property address
3 0 p V n/ I --U w-E 5 T
Spouse First Middle Last
6k./1 Yte
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number I las:5 digits) Other(please specify in.Pan 4 below)
I I I I I 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 stan P.rd deduction on this property. Each undersigned also understands that,by claiming additional homestead deductions 0
unla fully,he or shy ay re fable for back taxes and substantial financial penalties.
Own Signature t Date
)
- PART 4:ADDITIONAL INFORMATION -• -
•