Homestead_Field STATE FORM f)y+11Cr-YI TREASURERFOR.M i3-1A
.ArPRrw'EB BY STATE if 1%R°OF AfYli 1.1,. PRISM:14D nY tar UEPARnnENT OF LOCAL GOVERNMENT FeSASCE iCVI.I?'4.I
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one hontcvead sandanl deduction.As the receipt of this deduction become
more beneficial.there is more incentive than e'er for homestead fraud.homestead fraud causes higher tat bills for all:therefore.
ILEA 134-1-2009 requires taupayera who receive the homestead standard deduction to verify that they are eligible to recent the
benefit and to provide additional identifying informauun neceson'to allow county government to better monitor homestead
filings.This information will he kept rontidential and can only he accessed by authorized county officials.The Depanment of
Local Government Finance will we this information to create nols that will help cousin officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Field,William J
701 Kennedy Drive
Fort Branch IN 47648
6725
William J Field •
701 Kennedy Drive State Parcel Number Le2a1 Description
Fort Branch IN 47648-9773
111111111111111111111111111111111111111111111111 11111111 26-18-13-101-001.132-026 011-01132-00 PT SW NE 13-3-11 .4536 AC
D-27
PART 2:TAXPAYER INFORMATION
Owner 1 First Middle Last
(A,l/,'i ,14 T2scfif e/c/
fling Address(number and strut,city,state,and ZIP code) — - - - - &me as property oddis- — - — - -
Spouse First Middle Last
Mailing Address(Number and street,ciryt state,and ZIP code) ❑ Same as property address
Social Security Number(last 5 digits) Drivels License/Statc ID Number (last 5 digits) Other(please specify in Part 4 below)
scrag
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
�E ii_�lI . � ..� _
a� ." '{ CLAIM FOR HOMESTEAD PROPERTY TAX
}��: CREDIT/STANDARD DEDUCTION
�:,;� Sta,e Porm 5473 (R2 / 5-92)
yu
INSTRUCTIONS: See reverse side !or liling insfructions
- . � � � � ' , CERTIFICATION STATEMENT - .
•• �
;: , � I �' �=! '
i�� � ��
�ay i � - � wi��i N, i
—_y/�1 - certify that on the 1 st da�f I�
a) occupied as our principal place residence the following described real.property for which a Homesiead Property Tau Credit is hereby daimed:
�I(We) owned ❑ Are buying under contract � �
Have a beneficial interesi in the entiry that is liable for ihe property taxes on the property and that owns ihe property or is buying under a contract.
- CONTRACT RECORDED , ' � .
If buying on coniract, Pee Simple owner's name - � � ,
Recortler's ottice where contract is recorded Recortl number Page
Coumy
If any por7jefiof the residential stn
of ihe pr6perty utilized to produce
���-v��
Couniy
Addre55
PROPERTY DESCRIPTION
� � Tazing tli�trift (city rown, fownship)
I�� �W N� 13-3- I I ��f 5� ��
re or Ihe land not ezceetling one (7) acre that immediately surmunds that structure is used to produce ir�come, describe the use and portion
ime. �
3a- .
PROPERTV OWNED BY CLAIMANT IN OTHER COUNTIES� - �
Township County Township
certify the above statements are true, correci and wmplete.
dty, slate. Z/Pmde)
ASSESSOR USE ONLY �TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
� VALUE VALUE VALUE VALUE
Land not exceeding 7(one) acre immediately
surmunding residential improvements. (�� -
Other land (2)
Total land (line 7 plus line 2� (3)
Dwelling (4)
Resideniial improvements
Garage �g) - - ..
Oiher improvements (6)
Total impmvements Qine 4 through line � (7)
Total value (line 3 p�s line � (g)
I hereby certity the above is IrUe, corretl, and Signature ot Assessor Da;e signed
complete.
��ying action - Sgnature of Auditor Date signetl
19_Pay79_
Lesser of 1l2 Homestead
valuation or 52.000
ot AuAitor
STANDARD
S
I� ' _ . . -- ._