Homestead_Stone)... A .
ems, a CLAIM FOR HOMESTEAD PROPERTY TAX
}�E CREDIT /STANDARD DEDUCTION
`. State Form 5473 (R2 15-92) -
sia
INSTRUCTIONS: See reverse side for filing instructions.
t �
JUL 0 9 1996
ERTIFICATION STATEMENT TTA/]pp
"Ne _ at±r1A .N: _ certify. that on ne lst dA0&arCpR TT
�a) occupied as our principal place of residence the fo wing described real property for which a Homestead Property Tax Credit is hereby claimed:
�e) 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
OPERTY DESCRIPTION
County
Tow hi
County
Taxing istd t
�eby certify the above statements are true, correct and complete.
Signature of claimant
Parcel number
L I description _
o - 08o
S NO a3-1-11 5. o�
If 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.
,z- 0�3 - /ao
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
Township
County
Township
��.
�eby certify the above statements are true, correct and complete.
Signature of claimant
Address (number and street, city, state, ZIP cod I
ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE-
HOMESTEAD
VALUE
NON-RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Otherland
(2)
Total land (line I plus line Z)
(3)
Residential improvements
Dwelling
(4)
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plis line 7)
(g)
1 hereby certify the above is true, correct. and
complete.
Signature of Assessor
Date signed
eying action - Signature of Auditor
Date signed
L
STANDARD DEDUCTION ALLOWANCE
19 _Pay 19_
Lesser of 1/2 Homestead
Valuation or S2,000
S
Signature at Auditor
Date _9 G
I STATE FOAM!Mee t1Cd,f.✓II TREASURER FORM rR IA
♦PPMT'EO BY<r.VE MARDnF TTRL.NTS.9v PRFYVIHED BY 1110 DEPARMEYH(LOGLL GOVFANMO.'t FINANCE ICH.I-L+.I
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 - Individuals and married couples are limited to one homestead standard 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 1344--2009 requires taxpayers who receive the homestead standard deduction to verity that they am eligible to teethe the
benefit and to.pros'ide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will be kept confidential and can only he accessed by authorized county officials.The Ikpanment 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
_ Stone, Robert D/ Maria Kay
PO Box 281
Patoka IN 47666
430
Robert D/Maria Kay Stone
P O Box 281 State Parcel Number Legal Description
Patoka IN 47666-0281
Iul,iIIIIIIIIhttpllttulliull 1111111111111111111lllrrrll l 26-04-23-100-001.080-018 010-01080-00 PT S NW 231115.140 AC
60 i
r
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
�ob r Q 4,,;cl Sfo,�E
.ng Address((number and street,2ity,strata,and ZDP talc) -- - -- — - Same as property add s — - -- -- — --- --
Spouse First Middle Last
N\AMA K A'1 S tot-'E
Mailing Address(Number and street.city,stale.and ZIP code) ®'Sane as property address
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
PART 4: ADDITIONAL INFORMATION
•