Homestead_Georges (4) STATE FORM J'M In=n YMI TREASURER R110.173-1A
APPROVED BY SAVE BOARD OF Nn1UNTS._ow PRrnaaED BY GO DEPARTMENT Of LOCAL GOVERNMENT FIN ANCE K i.1-rim
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 net for homestead fmud.Homestead fmud causes higher tax bills for all:therefore.
HEA l544-2008 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
benefit and to provide additional identifying information necessary to allow county goverment to better monitor homestead
filinLn.This information will be kept conlidential and can only be accessed by authorized county officials.The Depanment of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION -
Taxpayer Name Property Address
_ Georges, Ronald M/Charlet R
R 2 Box 331
Elberfeld IN 47613
264
Ronald M/Charlet R Georges
8633 S SR 57 State Parcel Number Legal Description
Elberfeld IN 47613
26-20-28-200-001.095-001 001-01095-00 PT W NE 28-3-91.60 AC
D-19
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.
Spouse First Middle Last
Ck A7C i R. gee„c��
Mailing Address(Number and street,city,stale,and ZIP code) !pane 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
1 -
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (R215 -92)
ni.
INSTRUCTIONS: See reverse side for filing instructions.
as our principal place of residence the following described real
Ekin" ; (l f `i/ilZi m
my- 2
LA' certify that on the 1sFW
for which a Homestead Property Tax Credit is
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
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
' PROPERTY DESCRIPTION
County
Towns
Taxing district (city, town, township) ,
Parcel number
-o S-
Legal descri tion
W 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.
aG
acs-
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
Township
County
Towr et
by certify the above statements are true, correct and complete.
n re of Imant
Gt
Ad s (number and street. 01 state. ZlP mde) 1
!K\ - 9 / e
ASSESSOR USE ONLY _
TRUE TAX
VALUE
ASSESSED
VALUE.
HOMESTEAD
VALUE
NON - RESIDENTIAL.
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Valuation or $2,000
Signature of Auditor
Other land
(2)
Date si ned
-9�i
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) -
(6)
1 hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
--ifying action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19 _Pay 19_
Lesser of 112 Homestead
S
Valuation or $2,000
Signature of Auditor
Date si ned
-9�i
J