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CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (R2 / 5 -92)
INSTRUCTIONS: See reverse side for filing instructions.
FORM YEAR
HC10
.r' ^Ne) _r(J r LX.I �_ �/ C_.1[x,QY certify that on the 1 st day of March, 19_
e) occupied as our principal place of residence th [lowing described real property for which a Homestead Property Tax Credit is hereby 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 -
II buying on contract, Fee Simple owner's name -
Recorder's office where contract is recorded Record number Page
PROPERTY DESCRIPTION -
County Township
Taxing district (city, town, township)
Parcel number Legal description
-np c.� �j —3-5 7,& �j�
It 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.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County Township
County Township
&reby certify the above statements are true, correct and complete.
St lure of dai t
Land not exceeding I (one) acre immediately
surrounding residential improvements.
(1)
Address (number and street. ary. state. ZIP code) j Ok*� 3,11
/N –" I) '/ — y' //ny t
ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON- RESIDENTIAL
VALUE
Land not exceeding I (one) acre immediately
surrounding residential improvements.
(1)
Otherland
(2)
Total land (line I plus line 2)
(3)
I
Residential improvements
Dwelling
(4)
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 p!/s line 7)
(6)
I hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
'
I �"i g action - Signature of Auditor
Date signed
19_Pay 19_
Lesser of 1/2 Homestead
Valuation or $2,000
STANDARD DEDUCTION ALLOWANCE
S
Date
APR - 5 RECO
• MATE FOAM!!H,R_r-n1 TRFA91IIR FORM tS4A
AFIRthED BY MATE WHRD Or?AUNTS.No v. pin. mm BY ter DEPARTS-N. rrf LOCAL GOVERNWINT FINANCE le I.1_4.I
Gibson County Auditor
101 N Main - IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
/ ( PRINCETON IN 47670 Individual and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
J more beneficial,there is more incenme than exer for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
e
%'� HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to stay that they are eligible to reecho 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 be accessed by authorized county officials.The Depanntent of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead thud.
PART 1: PROPERTY LNFORMATION
Taxpayer Name Property Address
—.— Reed, Richard D/Jane A
No Location Description
3305
Richard D/Jane A Reed
C/O United Comm Bank
P O Box 148 State Parcel Number Lezal Description
Gillespie IL 62033-0148
It��tttrltlll 1111111111 �(t�tt��tt�tt(tt�lrtlrtrrlll 26-20-28-200-000.320-001 0001-00320-00 PT NW NE 28393.153 AC
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
•Tl.CACtrt ( Peed
ig Address(number and street,city,stare,and ZIP code) Same as property address
i)/0 E. 1005. Cl berge-iZ l V; '176 /3
Spouse First ,/ Middle Last
\ CUB All rt. Peed
Mailing Address(Number and street,thy,state,and ZIP code) ,Anne as properly address
X010 f 9005. q/her4e./J ic.DIJI -Y74 /3
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 elieible 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 Si at Date
PART 4:ADDITIONAL INFORMATION
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