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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
more beneficial.there is more incentive than exer for homestead fraud.Homestead fraud causes higher lax bills for all:therefore.
• HEA 1344-3009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to recehe the
benefit and to provide additional identifying information fleet-sat neergary to allow county government to better monitor homestead
filing.This information will he kept confidential and can only he accessed by authorized county officials.The Depanment 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
Staggs, David
302 S Willard
Fort Branch IN 476-18
7871
David Staggs
302 S Willard State Parcel Number Lezal Description
Fort Branch IN 47648-1658
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26-19-19-101-000.941-026 011-00941-00 EASTVIEW 22
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
Ilit g Address(number and street.city,state,and ZIP code) [ Same as property address
yo S: ly/Li AL/V, inRfgITIM/CH 1-111 1717k1./S>
Spouse Firstl Middle Last
Mailing Address(Number and street city,state,and ZIP code) ❑ Same as property address
Social SeeuritvNumber.11ast5.di¢usl_ Drixrrs.Licensc/Stare ID,Nlnnber_(lat 5 digits)_ _Other.Iplfase.specify.iaParti.below)_
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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
•
o,� °,�
y � CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
���� CREDIT/STANDARD DEDUCTION HCio
.�,�, • State Form 5473 (R2 / 5-92)
��eli_
INSTRUCTIONS: See reverse side for liling instructions.
ceriity �ha� on Ihe 75i day Of March. 19_
as our principa place of reside e following described real propeny for which a Homestead Property Tax Credit is hereby claimed:
� I(We) owned ❑ Are buying under contract
❑ Have a beneficial in;erest in the entiry ihat is liable for the pmperry taxes on the property and that owns the
CONTRACT RECORDED ; �q�, , ���„
I; Wyfng on contracL Fee Simple owner's name @i � ' �J���
�
Recorder's oflice where Coniraci is recorded Rec���ew �', J/' ,�ge�
AUDITO
PROPERTY
Coun;y
Ta�ing
�ce n(�mbry�l � I Legal tlescripiion "
� V I-�
If any portion of the residemial simnure or ihe lantl not exceetling one (l l acre that immetliately surrountls that stmcwre is usetl to produce i�ome. describe ihe use and ponion
of ihe propetly utilized lo protluce income-
PROPEFTY OWNED BV CLAIMANT IN OTHER COUNTIES � '
I County I TownShip Coun;y ITOwnship
� � i
�eby cenify the above statements are true. correct and complete. 5�_ awr ot claim�nt �
Address (numberandstreei. ciry. s�ate. ZlPmoe) �
\ � -�--`^�
ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VA�UE VALUE �
land not eaceetling 7(one) acre immediately
surrounding re5ideniial improvement5. I(' � I I
Oiherland (p) �
Totai land (line 1 plus line � (3) I
Dwelling (c) � I .
Residential improvements
Garage (5) I
Other impmvements (6)
Total improvemenis (line 4 thiough line � I(7) (
Total value (line 3 pbs line 7� I(g) I
I heBby certity the above is (me. Correct. and Signa;ure ol Assessor I Da;e sfgnetl
complete.
Veritying action � Signawre ol Autliror I Da�e signed .
19_Pay19_
Lesser of l/2 Homestead
Valuation or 52.000
Signawre o� Autlitor
STANDARD DEDUCTION
5
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