HomeMy WebLinkAboutHomestead_PickettCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (R215 -92)
Feu
INSTRUCTIONS: See reverse side for filing instructions.
FORM EAR
HC10
L
e) - �--I -L �1-! , l_(�(/W_!�fV \,,, certify that on the 1st day of March, 19
I upie sour principal place of residence the following described real property for which a Homestead Property Taxi s reb
l(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 bum ar Vc TACI.
CONTRACT RECORDED yt.
If buying on contract. Fee Simple owner's name AUDITO§?-?��
Recorder's office where contract is recorded Record number Page
Sm
- PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
PROPERTY DESCRIPTION
County Township
HOMESTEAD
VALUE
County -
Township
Taxing district fA ry.
., faw
hip)
P- elMm er
Legaldescription
(2)
If any portion of the residential structure or 0
land not exceeding one -1 I) acre that immediately surrounds that structure
is used to produce income, describe the use and portion
of the property utilized to produce income.
Residential improvements
Dwelling
(4)
-
13�
1k D
t)
Other improvements
Sm
- PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County Township
County Township
HOMESTEAD
VALUE
NON - RESIDENTIAL
- VALUE
Ole certi the bove em s rue, correct and complete-
Signature of claimant
AVIss (number and stree t. dry, state. ZIP rode) _
7
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)
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)
(S)
I hereby certify the above is true, correct. and
wmplete.
Signature of Assessor
Date signed
action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19_Pay 19_
Lesser of 112 Homestead
5
Valuation or $2,000
Signature of Auditor
Dates d
Y I A
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.VPROED BYSTTt emit°Ot Anti Lyn_}I/M PEr_AWDm BY TIE DEPAATn.Yr•i LOCAL GTTILMNI anA:YE M 4-1.IS24 I
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 e'er for homestead fraud.Homestead fraud cause higher tax bills for all:therefore.
HE.\ 1344-2000 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to creels°the
benefit and to prm'idc additional identifyinc inforrnatmn 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 lkpanman 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
Pickett, Jack A/Karen S
R I Box 269 O1
Francisco IN 47649
8513
Jack A/Karen S Pickett
P O Box 269 State Parcel Number Legal Description
Francisco IN 47649-0269
1t1u11ut1t11tuin11t1u11nutltltlln1t1nr11n1t1n1n1tl 26-20-05--1 110000--000.803-001 p;00803-00 PT NW NW 5-3-97.01 AC
/ y
PART 2:TAXPAYER INFORMATION
•Owner I Ydet). First
at-e Middle
�L/ Last
•g Addre'fs(number and street,city,state,and ZIP code)• Ern as prbpem address — — — -- — - -
`c 0 -&7 ,- G 9 ha.�uc-ace; ziyie n 174 319
Spouse First Middle Last
Mailing Address(Number and street city,state.and ZIP code) [J Same as property address
�✓ 7. c / 6''9
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
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