Homestead_Folsom (6) 1-
STATE POW i3W(R1/6tO) TIEISLRPR FORM ISM
APPROVED BY STATE BOARD OF ACCOUNTS.2W9 PRESCRIBED BY THE DEPARTMENT OF LOCALOOVERNMEYT FINANCE IC 61.1334.1
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N. Main Street - Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
Princeton,IN 47670 more beneficial,there is more incentive than ever for homestead fraud.Homestead fraud causes higher tax bills for all;therefore,
IMP 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 necessary to allow county government to better monitor homestead
filings.This information will be kept confidential and can onty be 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 Location Address
Racine,Bonnie
511 N West
Fort Branch IN 47648
6922
Bonnie Racine ilI111 0111III 110111111Th 1111111 111 111 BB
511 N West
Fort Branch IN 47648-1045
11111111111111111111111111111111111111111111111111111111111111111 State Parcel Number Legal Description
26-18-13-401-000.628-026 ROBERTSON ADD 30PT131
FILED
APR 6 2011
This folmsMM SwTbeureturned to County Auditor's office.
Please do NOT send this form back with your tax payment to the county treasurer.
Owner I First Middle Last
1300 N : Frtye I II? � So, r,
Mailing Address(number and street,City.state,and ZIP code) dJ Same as property address
J I 136St Stec E+ l rf azoch 4 i& P- 4/76 ya'
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 l'Si! .ture -�� .�/ . Date..
..•• • CLAIM FOR HOMESTEAD PROPERTY TAX veaR
drp 4' CREDIT/STANDARD DEDUCTION %1�� FORM �
9� -"- , ; _ J � HC10 �D
.``i�' State Form 5473 (R2/1-90) - `��
'°�� ,INSTRUCTIONS: See reverse side fo� filing instructions. q�
CERTIFICATION STATEMENT � �/��DG�O �
/(We) _(�1c��,t,Q������(n'(,Q� certify that on the 1st day of March , 19
I(We) occupied as our principal place of residence the following described real property for which a Homestead
Property Tax Credit is hereby claimed: L1�I (We) owned ❑ Are buying under contract
�Have a
� o,,
�.r�
County
e entity that is liable for the property taxes on the property and that owns the
a'contract. ' ' �
� CONTRACT RECORDED
Owner's Name
PROPERTY DESCRIPTION
Legal Description
town,
J ���
If any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that struc-
ture is used to produce income describe the use and portion of the property utilized to produce income.
PROPERTY OWNED BY
Counry
I hereby certify the above statemenis are true. correct and
number, city. state and ZIP code)
ANT IN OTHER COUNTIES
County - Township
ASSESSOR USE ONLY , TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON•RESIDENTIAL
� ' VALUE
Land not exceeding 1(one) acre immediately
surrounding residential improvemenis (�)
Oiherland (2)
Total land - line (1) plus line (2) (3) �
—Resideniial improvements� � -Dwetling {4)- - -- � - - - - - - - -
Garage (5)
Other improvements (6)
Total improvements - line (4) through line (6) (7)
Total value - line (3) plus line (7) (8)
I hereby certify the above is irue, Signature o( Assesor Date Signed
correct, and complete
Verifying Action - Signature of Auditor Date Signed
1989 Pay 1990
Lesser of 1/2 Homestead
Valuation or $2,500
Signature of Auditor
STANDARD DEDUCTION ALLOWANCE
1990 Pay 1991 1991 Pay 1992
Lesser of 7/2 Homestead Lesser of 1/2 Homestead
Valuation or $2.000 Valuation or $1,500
19—Pay 19—
Lesser of 1/2 Homestead
Valuation or $7,500
J