Homestead_Beard (2) MATE FORM S"M tle/•+r11 LPEWIAFR HAM:}IA
ArrErwEn BY STATE BMROOWMMP'R]m PREY-ROM BY lilt DEPMnHEYT OFLO:LL rovEtnMNr FINANCE M 4-1.I-r4.1
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 eser for homestead fraud.homestead fraud causes higher lax bills for all:therefore.
HEA 1344-2009 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 eocernment to better monitor homestead
filings.This information will he kept confidential and can only he accessed by authorized county officials.The Department of
Local Goverment finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Beard, Ray Jr/Delores G
301 li Vine
Foes Branch IN 47613
2863
Ray Beard Jr.
30 E Vine State Parcel Number Legal Description
FORT BRANCH IN 47648-1119
l l I t t I I1 r t I l I I t t 1I t 1 I I t 1I I I r t I I t 11I I111I l l l i t I l l I l l I l l I l 26-19-18-303-000.467-026 011-00467-00 WALTERS ADD 155 PT
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
Rs BEAM D
gong Address(n and street.city,state,and ZIP code) Same as property address
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) [] Same as properly address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Pan 4 below)
sex
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 Signet Date
VV \ \
PART 4:ADDITIONAL INFORMATION
� � CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
� Slate Fortn 5473 (R6 J 1-03)
Prestnbed by I�e Department ol Local Govemmenl Financ_
INSTRUCTIONS: See revcrse sidc !or liling msVUClions.
:1�°`� -F�RM--;
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APR 1 � 2004
YEAR
q, v � —r,���'��,�..-��:..1
I(We) � _.uceNry,fhanorTtheJsPday`ofMarch,20
�We) occupied a principal place ot residence lhe following described real property (or which a Nomestead Property Tac Credit is hereby daimed:
❑ I(VJe) owned ❑ fve buying under contract
, Have a beneficial interest in ihe entity ihat is Iiabie (or ihe property laxes on the property and that owns the property or is buying under a co�traU.
If hy�4�g on conVaa, Fee Simpie owneYS name
Remrdels olfice whera conVaC is reoorded
County
Tamship
Parcel number Le escrip y�pn'
D/ l - G�Y`/G, 7- � �1��,.CT,�a
N any porlion o( Ne resitlenllal structure w the land not e:caeding one
o( the ProP�Y uLl'¢etl tn produce iraome.
County
Toxnship
I hereby certi(y the above sWtements are W e, conect and complete.
Address (number end Stree4 ciry; s(ale, Z!P cade)
Recard number
T�ing
Page
I 14 Ihe P�Pen�7Y yin question:
�,� �p Real propeRy ❑ Mobile Home (I.C. 67.1-� .
wrtountls ihat swcture is used to produce income, desai6a the use and portbn
County
ve
i� �s�-�� �.;�.�, -��4z'e'.,� s-�'f,-:3.-r ?,-^y3'�v� a� �; �r�. - -. . , . . . y_ . .. -_•r __ �y§ s
-+rASSES50R�USEON'Ys.-�`�`� M'�" � 3TRUETAX� i�k ASSESSEDVALUE HOMESTEAD r NON;RESIOENTIAL �¢p<�
�-F�i`�'a,- . .:�r�.r.a.Mi'�r2�._ ���.�� �.'E.'_VAL:UE�-(-�v.t �. ATat00YsOFTiV �4,i�'VALUE�.� ��rao-',�.VALUE�"R'5���.
Land nol exceeding t(one) arae immediately , r�'?�'� �•-+�y� t ���
surroundin residentialim rovements. ��� S� n�z" ''�' ,.:�i -"
9 P �k_. � +'i+k-���� ��.���.
g'^:R . i::t� .
Other land . , �Z� �';�-�*ti' 1�
'»Y-;�� - -.�..
Tdal land (line 7 plus line 2) �g�
4f�v} iiH�7f. T ��3f.�Y���
Dwellin9 (4) �` �:�-"�-r��{{ ij '4'�;t'
Residenfiel improvementa w MnuaDy ��'�"�F"`�`��"�''�
Assessed Modle / Manu(aciured Hrn�e Gara e ��t �'"�'��
9 (s) � .� ._.��xa���-�
t- k : � �.
Oiher improvements (6) ���.�'^���:Es
�.�:..`'`���, ' ��
TUaI improvemenis (line 4 through line 6) ���
Tolal value (line 3 plus line n �g�
1 hereby certify the abOVe i5 We, corred, and Signawre of Assessw Data signed
complele. -
Vaifyirg aGion - Signature of Pudibr Date sgned _
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