Homestead_Mutchman (2). Ran
b CLAIM FOR HOMESTEAD PROPERTY TAX ppRM YEAR
i' CREDIT /STANDARD DEDUCTION Hclo a��
mow,' State Form 5473 (R2 15-92) t j
INSTRUCTIONS: See reverse side for filing instructions.
. "",.. '-_CERTIFlCATIONSTATEMENT=,'
I (We) ` I /� /1i�P�/yl APArik AaV5e 1st day of March. 19_
I_(We) occupied our principal place of residence the following described real property for whit aJ-lomestead ropQry Tax Crediiis hereby claimed:
I (We) own ❑ Are buying under contract
AU
Have a beneficial interest in the entity that is liable for the property taxes on the property an tfralEbG4�+
It 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
Taxing district (dry, town. township)✓
P •- y.lrti er O ��
Legal description
Signature of claimant
on/�
—3 ) rl -:� 2/9(
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.
a - fool
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
ol.
County
Township
County
Township
reby certify the above statements are true, correct and complete.
Signature of claimant
dress (number and street, dry. state, ZIP code)
. /
u
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 52.000
'
Other land
(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 plrs line 7)
(6)
1 hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
Ventying action - Signature of Auditor
Ak
Date signed
�• - STANDARD DEDUCTION ALLOWANCE'_,
19_Pay 19_
Lesser of 1/2 Homestead
S
Valuation or 52.000
Signature of Auditor
Date signed
• dWWt FORM 3s iRl/Nnl InFASL'tEA/ORM 31A
APPRrwE°BY R\IE WNW M MY.RI%FS.WN PRIS 1BED BY TIM DrPAATrr.YT OF LOCALCA[R.WiuCr FINANCE ir a-1.1-2:-A./
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRNCETON IN 47670 Individuals and married couple are limited to one homestead Atandard deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than 0 C for homestead fraud.I tomes-read fraud causes higher tax bills for all:therefore.
® HEA 1344-2009 requires taxpayer who receive the homestead standard deduction to verify that they are eligible to receve the
benefit and to pawide additional identifying information necessary to allow couny government to better monitor homestead
filings.his information will he kept ronlidmuial 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
Mutchman, John /,
122 Box 300 B Q I/
Elberfeld IN 47613 �ko I\
3310 W ou
John Mutchman '_^I
R2 Box 300 B State Parcel Number Legal Description
Elberfeld IN 47613-8436
26-20-28-200-001.755-001 001-01755-00 PT NW NE 28 3 9 2.637 AC
Itllllllltllll IlielleIIIIttlt tlttllttlltttlllllttlttlttll 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.
•
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
Jahn Lce TY11t-a-kImEti
illtg Address(number and street_city,sate,and ZIP code) ❑ Same us property address
2063E Moos Fiber-Feld, 4 P r I-{7(I3
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as propeny address
Social Security Number(last 5 digits) ` Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
--
Isirat
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 1 Si tu Date
all