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Homestead_Johnson (9) STATE FORM!INAIR=F'-HI TREAS11R[R FORM:NIA APPROVED BY Si VE&ARD OF ACC0I T5]nx PRENTAIRtD BY nit DEPARIM�rrl{LOCAL GOVEILNNIENT FINANCE II'H.I.22AI Gibson County Auditor 101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS PRINCETON IN 47670 Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes 41 more beneficial,there is more incentive than ever for homestead fraud.Homestead fraud causes higher lax bills for all;therefore. HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the benefit and to provide additional identifying informanon necessary to allow county government to better monitor homestead filings.This information will he kepi cnnlldential and can only be accessed by authorized county officials.The Uepannent of Local Government finance will use this information to create tools that will help county officials eliminate homeueal fraud. PART 1: PROPERTY INFORMATION Taxpayer Name Property Address Johnson, Donald E/Betty A 605 F Mulberry Fort Branch IN 47648 7877 Donald E/Betty A Johnson 605E Mulberry State Parcel Number Legal Description Fort Branch IN 47648-1639 ltlnllntlFllu FluliulnnlltliutFllFlR�ulirutltltiu tll 26-19-19-102-000.003-026 '111410003-00 CLAR-ENCE TERRACE A PART 2:TAXPAYER INFORMATION Owner I / First Middle Last Bona/d ca j e/Ie ,dolt n son 4,1 g Address(number and street,city,state,and ZIP code) — - - — J Same as property address - - - - -.-- - &OS E ma/bec/y 5( , 2/. Branch _271 y ,6V 7 Spouse First Middle �— Lau & /Iv Rfir2 ■ ohns©0 Mailing Address(Number and street,city,state,and ZIP code) Same as propene address -- —LP O-3 r,Y77/,6erly 5F c 7/ iate/ - 7--21:-/I-9--(7-7-6--(7• =-- 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 • .a�"�° o � L 14 • i' i� '4.._ ,�-•%� ,- CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT/STANDARD DEDUCTION State Fortn 5473 (R2 / S92) INSTRUCTIONS: See reverse side !o� filin4 instructions. [FORM YEAR 4� - �iHCI�� ocT z o isss � � CERTIFICATION STATEMENT � , _ !�-_' _ `!' /J Jf �' �u G!BSO�a �'i,;.: '�.��^'-o' c. I(We) certify that�on tFie 1st`dey of March, 19_ I(VJe) occupi as our principal place of residence the follovring described real prop or which a Homestead PropeRy Tau Credit is hereby claimed: �I (We) owned ❑ Are buying under coniract Have a beneficial interest in the entiry that is liable for the property tazes on the pmperty and that owns the�property or is buying under a contract. CONTRACT RECORDED - � If buying on contract. Fee Simple ownefs name Recorders oHice where contraci is recortled Recortl number Page " PROPERTY DESCRIPTION Counry Township Tamg tlistric ciry, fown. fownship) Parcel number legal descnption oLl- �c�3- If arry portion oi Ne residen6al struaure w the IarM rroi exceetling one (1) acre ihat immediatety surrounds ihat sWCture is usetl to produce income, describe the uu and portion of Ne pmperty utilized to produce income. - PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES Counry Township Counry Township - Signa� of daimant �ereby certify the above statements are true, correct and complete. Address (nomber and street, city. 41 te, Z/P code) - Cc O' �, sa$�'. � a�Q /v `f 7�v Y 8' ASSESSOR USE ONLY TR E TAX ASSESSED HOMESTEAD NON-RESIDENTIAL VAIUE VALUE VAIUE VALUE Land not exceeding 1(one) acre immediatery (�� suvounding residential improvements. - - Otherland (2) Total land (line 7 plus line 2) (3) Dwelling (4) Residential improvements Garage (5) Oiher improvements (6) Total improvements Qine 4 through line 6) (7) Total value Qine 3 plus line 7J (8) I I hereby certify the above is irue, correct, and Signature of Assesor Date signed complete. Verilying action - Signature of Autlitor Date signed STANDARD DEDUCTION ALLOWANCE 79_ Pay 19 _ Lesser of 1/2 Homestead � Valuation or 52,000 � Signature ol Auditor Date signed