Homestead_Johnson (12) tr�l
I. STATE ! / F .7S-IA
_ ArrK(wED BY SLATE.M PInMYya\Tl.yr PAFYAI➢[i16Y nil nFPMTNFYIfF LOCAL Car0.YNFAT iEsNcti Ctrl.l-'4.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples arc limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than ester for homestead fraud.Ilomestead fraud causes higher tax bills for all:therefore.
HEA 13-14-2009 requires taxpayers who receive the homestead standard deduction to verity that they are eligible to reeehe the
benefit and to provide additional identifying information nceesswy to allow county government to better monitor homestead
filings.This information will be kepi confidential and can only lv accessed by authorized county officials.The Department 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
Johnson, David T/Ruth S Life Est
Trust
601 F Sinclair
Foil Branch IN 47648
7661
David T Johnson
601 E Sinclair State Parcel Number Legal Description
FORT BRANCH IN 47648-9797
�t�n��nt�t�tnt�n�tu�t�t�u�ntt�ttutn,lll lllu l,l 26-19-18-301-000.711-026/ 011-00711-00 HILLCREST 33
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
David T, 3-0 hhs0IA
/ng Address(number and street,city,state,and ZIP code) - - -- - — Same as property address- - - -Loot E . Since irSt Fort Qleat1et Al I /-ti6-4Q
Spouse First Middle Last
tae S Johnson
-
Mailing Address(Number and street,city,state,and ZIP code) Z Same as property address
dot E . S nekai ►- S7' Fart Al-on el, 2.N 9- `tCo 4-Kg'
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.
Own Si ature Date
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CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Fortn 5473 (R2 / 5-92)
INSTRUCTIONS: See reverse side !or /iling instructions.
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ER FICATION STATEMENT
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I(4Ve) �l�Y�i'tfie 1st day of March, 19_
I(We) occupied as our principal place of residence the foi ng described real property for whi a stead Property Taz Credit is hereby claimed:
❑ I(We) owned ❑ Are buying under contract
❑ Have a beneficial interest in the entiry that is liable for the property taxes on the property and thai owns the property or is buying under a contract.
CONTRACTRECORDED
If buyiig on conVact. Fee Simple ownefs name �
Recordets office where conVact is recorded Record number Page
PROPERTY DESCRIPTION
Counry Township Taxing tlistrict �ciry, (own, mwnship)
P I number Legal tlescription
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If any portion of Uie resitlential siruc[ure or the land not exceetling one (1 acre ihat immediatety surrounds Nat struc[ure is used to produce income, descnbe the use antl portion of
Ihe D�operty utiizetl to produce income.
PROPERTV OWNED 8Y CLAIMANT IN OTFIER COUNTRIES
Caunry ' Township Counry Township
Signa�of claimani
ereby certify the above statements are true, correct and complete. '
Address (numbei and stre 1, ciry, stafe, ZIP code) '
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ASSESSOR USE ONLY TRUETAX ASSESSED NOMESTEAD NON•RESIDENTIAL
. VALUE VALUE VALUE VALUE
Land not exceeding 1(one) acre immediately (� �
surrounding resideniial improvements.
Otherland (2)
Total land (line 7 plus line 2) (3)
Dwelling (4)
Residential improvemems
Garage (5)
Other improvements (6) '
Total improvements (line 4 through line 6J (7)
Total value (line 3 plus line 7) (8)
I hereby certi(y the above is true, cortect, and Sgnamre ot Assesor Date signea
complete.
Verifying acfion - Sgnature of Auditor Date signed
STANDARD DEDUCTION ALLOWANCE
19_ Pay 19 _
Lesser of 1/2 Homestead r�
valuation or S2,0o0
SignaWre oi AuAitor \ Dare si n
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