Homestead_YoungI
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Form 5473 (R51 10-01)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
CERTIIFICA11
PT_ i A
FORM YEAR
7
I(We)A/(AA110f %1 .1 "n %A^( M4Ck - certify ton tWls"ay olVa-rch, 20
I (We) occupied as our principal place of residence the follow de ibed real pro for which a Homestead Property M t it is h289claimed:
El I (We) owned El Are buying under contract dy
'Have a beneficial interest in the entity that is liable for the property taxes on . the property and that owns the pro (e;4 or is buyiV9 u 4 a coriqact.1
CONTRACT RECORDED
It buying on contract. Fee Simple owners name
Recorder's office where contract is recorded Record number Page
M.,
PROPERTY DESCRIPTION
County
Township
Taxing district (city, town, township)
Parcel number,
Qyla� 0*0 7 -on,
f-9ffibS-(0j3--)
Is the property in question:
❑
q
u/ V
ZI 419 410 fol
Real property Mobile Home JI.C. 61.1- 7)
If any portion of the residential structure or the tend not exceeding one (1) acre that i d unrounds that structure is used to produce income, describe the use and portion
in
.11
of the property utilized to produce income. lb, T.
Q•413
K _fZoc _.'�7; - PROPERTY OWNED BY CLAIMANT IN OTHEWCOUNTIES
County
Township
County
Township
I hereby certify the above statements are true/,/. wifect and complete.
d s"es
;0X'0§`r' XO&W , //tl/
u/ V
ZI 419 410 fol
/_ X I
-,
ASSESStDVALUE
AE
�
'NON-RESIDENTIAL` TIALt-
MYN-T U SE ONLY
AT100%OFTTV'
VA
Land not exceeding I (one) acre immediately
..37
surrounding residential improvements.
Other land
(2)
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
Residential improvements
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
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
ST
ANDARDMEDUCTIONALLOWANCE
t)
MW 20_ Pay 20
Lesser of 112 Homestead $
Valuation or $6,000
Signature of Auditor Date To to V
t�SO 41 L4) ZAA��
•
STATE FORM!)N.in 1,W1 TREASURER FORM:3.4A
A?PWW ED BY STATE BOSRD OP"MOUNTS.'m+ PRESCRIBED BY PIE DEPARTNeff OF LOCAL GOVERNMENT FINANCE IC 4.1.t-r-A.l
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
V more beneficial,there is more incentive than riser for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to recent the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings_This information will be kept confidential and can only be accessed by authorized county officials.The Depanntent 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
_ Young, David L/ Nancy
RI
Patoka IN 47666
220 •
David L/Nancy Young •
5260 N 4tt Rd State Parcel Number LeEal Description
IN 76
Patoka IN 47666-9112
26-05-58-056-000.748-018 010-00748-00 PT MD 561-1010.74 AC
IlIttlItilltIluellosillitIll I I ttttt tit I I ti I t I t I I tt I I III PT MD 57 1-10 2.434 AC D-12 C-1
V ,
PART 2:TAXPAYER INFORMATION
Owner I First Middle Lass
bawd Lee, 70u49
��Address(ntiiaber and street;essay;state,and ZAP wile)— --.- — <Sutue us properly addrtaa ` -- - _
50?6° AC /�/i°Aert gal./ % �o�.4�9 , /1 /7/7 6
I
Spouse First Middle Last
/Van ey )/(0t4Aq
Mailing Address(Number and street,city,state,and ZIP code) ErSmne as property addred
ro?,6 a A7 7-4/P Peer �°d, iq)o%r ,/ ///, 4/7666
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
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