Homestead_Clark LIAR FORM`!!M Inr YNI MASU D FORM TS-/A
Al./ROVED BY CIVIL BOARD OFM'O.'.TS.-`Iry r,L41UBEO BY TM'DEPARTME4TOF t *L rxwrtYMtwr FINANCE IC(.1.1-124.1
Gibson County Auditor
101 N Main . IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead+tandahl deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than e'er for homestead fraud.Homestead fraud causes higher tax hills for all:therefore.
• HEA 1344-3009 requires taxpayers who receive the homestead standard deduction to serify that they are eligible to reeehe the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will he kepi confidential 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 1: PROPERTY INFORMATION
Taxpayer Name Property Address
' Clark, L/Rebecca A
812 E Strain
Fon Branch IN 47648
2903
/ Rebecca A Clark
812 E Strain State Parcel Number Legal Description
Fort Branch IN 47648-1429
11111111 III I I I I I I I I I I I I I I 26-19-18-304-000.742-026 /011-00742-00 PT SW 18-3-10.29 AC
ra 1 rut ii ii turf 1 rl rl 1 1 _11_1_11_1.. l_//
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.
S•� - First Middle Last
2E8tcc,9- Aly7V c L.'Mg
Mailing Address(Number and street,city,state,and ZIP code) fTil Same as property address
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
-
•
•
.�•°•�• CLAIM FOR HOMESTEAD PROPERTY TAX �
d� `� ' .
::'"`` � �; CREDIT/STANDARD DEDUCTION
a ; '—'j
� State Form 5473 (R2/1-90) "
�'°�• � INSTRUCTIONS: See reverse side (or liling instructions.
I (We)
CERTIFICATION STATEMENT
_ __ FORM _ _
HC10
�
that on the 1st day of March , 19�
� 'We) place of residence the foll ing described real property for which a Homestead
Property Tax Credit is hereby claimed: I(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 it under a contract.
- CONTRACT RECORDED
on contracl. Fee Simple Owner's Name
office where contract is recorded
County
PROPERTY DESCRIPTION
Record Number � Page
p,�rcel Number Legal Description
� ��-<���ya� ��.S.e.u-l8- 3 m,a���
If any.portion of the residential sVuciure or the land not exceeding one (1) acre that immediately surrounds that struc-
ture is used to produce income describe the use and portion of the property utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
ASSESSOR USE ONLV TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL
' VALUE
land not exceeding t(one) acre immediately �
surrounding residential improvements (�)
O[her land (2)
Total land - line (1) plus line (2) (3)
Residential improvemenis Dwelling (4)
Garage (5)
Other improvements (6)
Tolal improvements - line (4) ihrough line (6) (7)
Total value - line (3) plus line (7) (8)
I hereby certify the above is true; Signa[ure of Assesor Date Signed
correct, and complete
Verifying Action - Signature of Auditor Date Signed
STANDARD DEDUCTION ALLOWANCE
1989 Pay 1990 1990 Pay 1997 7991 Pay 1992 19—Pay 19—
Lesser of 1/2 Homestead Lesser of 1/2 Homestead Lesser of t/2 Homestead Lesser of 1/2 Homestead
Valuation or $2,500 Valuation or $2,000 Valuation or �7,500 Valuation or $7,500
Signature of Auditor Date Signed