Homestead_Donohoo (3) Stitt iOiM 3'MIP:I tot TRr.4SUIIA FORM TS-IA
AP/ROVED BY'TALE BkMOM'MTl TS.bn etISRTED BY THE DETnrtn rr OF LOCAL CRr IR`MFTT MA\EE tt'sI.I-r4.1
Gibson County Auditor
101 N Main I IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
iiRINCETON IN 47670 IndividuaLs and married couples are limited to one homestead standanl deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than ester for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
HE.\ 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they ale eligible to reccise the
benefit and to pnn'ide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will he kept confidential and can only he 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
_ Donohoo, Melissa
R2 Box 294 A -
Elberfeld IN 47613
8776 (rr
Melissa Donohoo
8514 S 850E State Parcel Number Legal Description
__—_ _ _Elberfeld IN 47613-8434 — _ — _ _ _ _ _
u
II n III 1111111111111111111111111111111111111111111 26-20-27-100-001.216-001— 001-01216:00 PT NNW NW 27392.00 AC ` -
r r r `y/ D-19
Spouse AA First .r-� Middle I^ Last
01�' I �a_ II.,,F1,tIG�� i��l!14 Ant I �nnnYlbn
Mailing Address(Number and street,city,state,and ZIP code) 1-7-Same as property address
2S IuS ?goILI I fieL.-Cc( d (1) 1-1 -1 i ,1J( 3
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.
•
CLAIM FOR HOMESTEAD PROPERTY TAX
e CREDIT /STANDARD DEDUCTION
• State Form 5473 (R2 15-92)
residence ihe following described real property for which a Homestead Property Tax Credi h i re med:
E] I (We) owned ❑ Are buying under contract 0 C O
❑ Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the prope =ying u er oniract
CONTRACT RECORDED Aa GIBSON COUNT
If buying on contract, Fee Simple owners name
Recorders office where contract is recorded
Record number
Page
PROPERTY DESCRIPTION
County
Township
Taxing district (city, to nship)
Parcel umber
C0 /-o/ 6--cD
Legal de ti
z�-) 220 627 -3 S' a Q_
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.
O�w - o1uJ a %- lQO -00/. 6;A; _v6/
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
County
Township
County
Township
certify the above statements are true, correct and complete.
Si naa [ere,of claimant
ereby
A4dress number and street, city, state, ZIP code)
ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON - RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
(1)
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)
1 hereby certify the above is true, correct, and
Signature of Assesor
Date signed
complete.
verifying action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19_ Pay 19
Lesser of 1/2 Homestead
S _
Valuation or 52,000
Sr re of Audi r
Date Sig ad ,�
c� -3 / -0�