Homestead_Dean STATE FORM'naRA I R1 Hrvl TRrAS1i AIR FORM TS-IA
APPMFEDDY M OE',CAROM'ACctt.NtS.bra Plc-IMBED BY no nrPARneIT If local nOvtLMMENr FINANCE ICH.I-LLD
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
.
PRINCETON IN 47670 Individuals and married couple.arc limited to one homestead standard deduction.As die receipt of this deduction becomes
more beneficial,there is more incentive than ever for homestead fraud Homestead fraud causes higher tax bills for all:therefore.
�^ g I HEA 1341-2009 requires taxpayers who receive the homestead standard deduction m verify that they are eligible to receive the
}tAll,..i, ®g9 , benefit and to provide additional identifvinc infomtalwn necessary to allow county government ro better monitor homestead
i
I filings.This information will he kept confidential and ran only he accessed by authorised county officials.The Ikpanment of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
APR 7 L01° PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
` aa, /et Dean, William H/Brenda J
GIBSON COUNTY AUDITOR SOO l:lohn
Fort Branch IN 47648
2841
William H Dean
800 E John
• State Parcel Number Legal Description
FORT BRANCH IN 47648-9789
11111111111111111111111r1r11111111r11rr1r111111lrr lllllllrrlll 26-19-18-302-000.630-026 011-00630-00HILLCREST 77
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
WI//iA4, /IA2TLPEy `SEA Al
•tag Address(number and street.city,state,and ZIP code) Same as property address
?Do f To 5 T FORT 'x RANCn JAY 4' 7-,69. f
/
Spouse First Middle Last
/3 REMali 1E4N DEA N
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as property address
?-OOE J0 2N ST F D2 7- &2A/VC/i /iV, 4/769 EC
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 °
CLAIM FOR HOMESTEAD PROPERTY TAX
-° � CREDITISTANDARD DEDUCTION
t �� Slate Form 5473 (R5l 10-01)
••� Prescribed by Iha Departmenl o( Lacal Govemment Finance
INSTRUCTIONS: Sea 2verse side lor filrng instructions.
FORM YEAR
C6 �
APR 16 2003
� M�e) �J JL�/�V 1��- 1�L //U(/`�+CSCX7� tJ/ v�� certify Ihat"q�.(4easEdaf-o1�A+iarch; 2Q�`'`�
�occupied as our prindpal place of residence the following described real property tor which a Homestead Prop rCyi#ac�Ciedit Is heieby daimed
I(VJe) owned ❑ Are buying under contract
� Have a benefidal interest in the entiry that is liable for the properry taxes on Ne property and that owns the properry or is buying under a wntraG.
If buying on conVact, Fee Simple owners name
Remrtlels ofice where contraq is
Couny Tamslilp
� n—m6e O--� ^. O� al de:
.J\J
H any ponion of the residenUal atruqure w the land nW
ot the property ulif¢ed tn produce i�ome.
County
Twvnship
ace t�at
I hereby certify ihe above statements are We, carred and complete.
(number end sVeet, ciry, sfate, ZIP cade)
Land nol exceeding 1(one) acre immediately
surrounding residenGal improvements.
Other land
Tdal land (line i plus line 2)
Dwelling
Residentlal improvements
Garage
Other improvemenls
T�al improvements (line 4 through line 6)
Total value (line 3 plus line �
I hereby certify ihe above is We, corred, and
complele.
Verifying ad"an - Si9nature oflwditor
��)
1Z)
(3)
(4)
(5)
(6)
(�)
IB)
SgnaNra ot Pssessor
Record number
Pa9e
Taing Gi5(ri (�own. to p
�
� Is the pmperty in que �:
Reai v�oaertv ❑ rowcue Nome p.c. s�.�-� .
iatety wrrounds �hat sWCWre is usad W produce incwne. describe the use antl portion
Counry
of Claiman�
Date signe0
Date signed
����,��'"'-� �''b`�;'p,����?�,-X'�srnrrnaRti.oeoucnoriauowaricen�`�••�^�'- �'�#�� `� � °" "'
's.'E2+�SY4t .l.85_-�-+��"�^."��t_`�� ��Y
20 _ Pay 20 _
Lesser of 12 Homestead g
Valuation or $6,000
Si9naNre of /wditor ' Date signed