Homestead_SherwoodCLAIM FOR HOMESTEAD PROPERTY iAX FORM YEAR
} CREDIT /STANDARD DEDUCTION HC10
Slate Form 5473 (R6/ 4-03)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
I (We) certify that on the 1st day of March, 20_
(We) occupied as our principa8pW residence the following described real property fol which a Homestead Property Tax Credit is hereby claimed:
❑ I (We) owned ❑ Are buying under contract -
GI 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 under a contract.
1 CONTRACT 'RECORDED::::- �'rl:,!'
If buying on contract, Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
< zTk?s erYrz•": e;..'.+`.." e+.:'-%= �%, �, dm?tX ".:R'A3.3PROP,ERTY.DESCRIP,T
N'z i, „ri :. - -: b:`' :e.- ..3:!;?t,f:
County
Township
Testing dis
city, town, township)
Parcel number
L 1
ption Is
a property in question:
❑ Real property ❑ Mobile Homo ( /.C. 6-1.1 -7)
H any portion of the resMential structure or the land _n tea gone ( )acre That immediat ty surrounds that structure is used to produce income, describe the use and portion
of the property utilized to produce income.
4P, �PROP.ERTKOWNEDiBYCL'AIMANT IIJOTFiER- COUNTIES%'x'�'
t IRUE TAX 7 k
Y'a'.VALUE'ixo_ a
County
Township
County
Township
hereby certify the above statements are true, correct and complete.
Signature of claimant
Address (number and street, city, state, ZIP code)
�t t +" e `�
:ASKS- ESSR$E' LY $`2`tii�,!� .
t IRUE TAX 7 k
Y'a'.VALUE'ixo_ a
ASSESSEDNALUE
_AT 100 %OFTTV,
�3HOMESTEAD �
�?rVALUE..'''?aEyVALUErh:.i.,+'
r- NON RESIDENTIAL 'li:
�[l
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
n
Other land
(2)
yt'dc „� �7
M-
Total land (line 1 plus line 2)
(3)
Residential improvements or Annuaity
Dwelling
(4)
4, `
Assessed Mobile I MantrFactured Home
Garage
(6)
.��••,_,�
"
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(6)
I hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
20 _ Pay 20 _
Lesser of 112 Homestead
valuauon or 535.000
5
HATE Ford R.IK:t Wl MASUUI FORM,2, IA
.V1PP'En BY[TSTE Omar)Or MITAtsts.9M rtE.ATIBIED BY 111E DEPARTE.4TUE LOCAL rAV-RMM.rxT FNASYE M41.1.4.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead standanl deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than net for homestead fraud.Homestead fraud causes higher tax 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 information nxrsary to allow count'government to better monitor homestead
filing.This information will he kepi confidential and can only be accessed by authorized county officials.'the Ikpanment of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION
Taxpayer Name Property Address
Sherwood, Becky
12939 F 1025 S
Oakland City IN 47660
9330
•
Becky Sherwood
PO Box 52 State Parcel Number Legal Description
LYNNVILLE IN 47619-0052
III I I I I I I I I V I I I I I I I I 26-21-32-303-701.824-001 001-01824-00 BLDG ON LSD GRND
t tt ttE t t tt Irr Irtt t tut t t t ttr t t tt Lynnville Park Lot 29
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
e-Rage S H-&,z u Out 051--174
®ng Address(number and street,city,state,and ZIP code) -- - 2.-Sfime as property address - — — — — . _
I1/ 7>DEe,JanC 2.( oj 5c LC7A / #3 £l) (?
/
Spouse First ` ( Middle Last
Mailing Address(Number and street,city.state,and ZIP code) j.Sante as property address
Social Security Number(last 5 digits) Driycrs License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
•
Siva
PART 3:CERTIFICATION
Each undersiymed 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 standarddeduction 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