Homestead_Harris tlAIE I ORM MEMOR:'r!WI 1ELASURER FORM TS-IA PARTHENT OF LOCAL GOVERNMENT FRZANCE IC APPROVED MPORTANTTNOTICETO HOMESTEADrP PROPERTY OWNERS LS-2.24
Gibson County Auditor
101,N Main
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 eser for homestead fraud.Homestead fraud causes higher tai bills for all:therefore.
•
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they me eligible to recene the
benefit and to provide 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 authorised county officials The Depanment of
Local Government Finance will INC this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Harris, Walter Allen/Donna Cliftene c
9a 3 , (kro
-R-t--
Lynnville IN 47619
•
9285
Walter Allen/Harris
9030 S 1150 E State Parcel Number Legal Description
Lynnville IN 47619-8812
Irlrrll rrrlr ll Ilitlttlttltlttltrttlittltltrlltll ��� 26-21-30-300-000.304-001 001-00304-00 PT W SW 30-3-8.872 AC
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
•ng Address(number and street.city.state,and ZIP code) — — lsnme as property address -- --- — • - _-
\0 • S IISG t—AsNNN\( N 47619
Spouse First Middle Last
Mofbil‘S R CL\ E NR:RiS
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as property address
go3o S ( Is o E L-`((UN VIILE ' N `170 !9
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
unlaufitlly,he or she may be liable for back taxes and substantial financial penalties.
Owner I Signature
„-C ` / Date
-
CLAIM FOR HOMESTEAD PROPERTY TAX
`= CREDIT /STANDARD DEDUCTION
State Form 5473 (R21592)
uu
INSTRUCTIONS: See reverse side for filing instructions.
E U IJV4
nCERTIFICATION STATEMENT ,/ ,c.�
certify that4tie`j�f.gyk.of/1
occupied as our principal place of residence the following described real property for which omestead Property Tax rt is ereby claimed:
1 (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.
If buying on contract, Fee Simple owner's name -
Recorder's office where contract is recorded Record number Page
- PROPERTY DESCRIPTION
County
Township
Taxi district (city, town, township)
Parcel number
O _00_5,_1 0 -cx�
L I description
V W -5 vil . 3o - 3_
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.
-,300 - 0 00 -
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County Township
County Township
Waby certify the above statements are true, correct and complete.
SLof.a!Qre of claimant \
K kilo,
Address (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
surrounding residential improvements-
(1)
Signtfirif of Auditor Date signed
_70- 95
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 pfrs line 7)
(g)
1 hereby certify the above is true, correct. and
complete.
Signature of Assessor
Date signed
rig action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19 _ Pay 19
Lesser of 1/2 Homestead
Valuation or $2,000
$
Signtfirif of Auditor Date signed
_70- 95
FJA