Homestead_ThompsonCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
e _ State Font 5473 (R2 15-92)
INSTRUCTIONS: See reverse side for filing instructions.
FORM YEAR
HC1�j0
CERTIFICATM STATEMENT Y n ,. 9
I (We) rtity that on the ?t day of March, 19_
I (We) gpeupied as our principal pl a of a dente the following described real prdperty for hich a Home ad Prop@rVax Credit is eby aimed:
1 (We) owned ❑ Are buying under contract - /� Gh`t•..,t �.�,; -TV I^ FOR
❑ 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 owners name
Recorders office where contract is recorded
Record number
Page
PROPERTY DESCRIPTION
County
Township
Taxing di 'ct ( , town, hip)
f
ar el tuber O�O O
al tlescription
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.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
County
Township County Township
Signature of Uarmant
areby certify the above statements are true, correct and complete.
I
ess in ber ndstree ci 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)
Otherland
(2)
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 plus line 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
19_ Pay 19
Lesser of 1/2 Homestead
luation or S2,000
S
Signature of Auditor
Da;asspned — O O
Arm sED WC c4-Th wR r FDSs EIt 1.1-S:T
nriMT'En BI'c1LTEBMRDnF.Hrvr:\lc_:VN rAf AAlp(DpY illf DrrARiNEYi(iLOCAL CANT R.YNfA'IfQ:A\eE IC VI.I•:2-4-.l
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 e'er for homestead fraud Homestead fraud causes higher tar bills for all:therefore.
HEA 134-1-3039 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to remise the
benefit and to provide additional identifying infono:mmm necessary to allow county government to better monitor homestead
tiling. This information will be kept confidential and can only he acre:sed by authorized county officials.The lkpanmdnt of
I.LCal Government Finance will we this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY LNFORMATION
Taxpayer Name Property Address
Thompson, Alan Jay/Rachel Rae
R I Box 237
-- Patoka IN 47666
431 — ` — - -
Alan Jay/Rachel Rae Thompson
2401 W 450 N State Parcel Number Legal Description
Patoka IN 47666-9035
I r�trlittt Irlltrtllttrllt tltlt tlltr trrllt rlt�tllrrrrttlir rllt1 26-04-23-100-002.077-018 010-02077-00 PT NW NW 231115.00 AC
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• PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
/4/a A/ a A \I am 6'0Al
— .
og Address(numbrt and froc eity state,and ZIP code)—.—— - — .__ _ me to pmp.:ny ras— — — --_ - - - _
0? y0/ fit/ 164 Al .foio1/4- 1 '176/ob
Spouse First Middle Last
IZ a c le_1 (R.0,_ 11D rn S O n
Mailing Address(Number and street,oily,state,and ZIP code) 13-esame as propmq address
a Lib I W q _n Al }yak ka_ .L ivl q 76 A In
.
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 lia le for back taxes and substantial financial penalties.
Own 1 1 nature L)etc
PART 4:ADDITIONAL INFORMATION
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