Homestead_VoightCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Form 5473 IRS 110-01)
Prescribed by the Department o f Local G ovenment Finance
INSTRUCTIONS, See reverse side for filing insimcdons
I t FIL
1UUL
CERTIFICATION STATEMEN I
I (We) rl _4 t st day of March, 20
I (We) occffed as our principal place of resident Ue following described real property IQ, , — �16�d,p niTOR Tax Credit is hereby claimed:
,yi or, too hj� ropeTty
I "e) owned ❑ Are buying under contract
0— iave 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.
i.'. W CONTRACT!RECORDED
�-
If buying on contract, Fee Simple owners name
Recorder's office where contract is recorded Record number Page
; p
-
'PROPER TY.DESCRIPTION , ,i., -_ -... - I .,
County
Township
Township
Taxing district (city, town, township)
661
mber
- *A
I hereby certify the above statements are true, correct and complete.
property n que ti
nature oI#Aaimiiutt
4fM=
603 8 0
A 1-32
-q Realsproonperty ❑ Mobile Homo (I.C.6-1.1-7),
If any Portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that structure is used to produce income, describe the use and portion
of the property utilized to produce income.
__J � 7�
111PROPEFiTY6WNED BY CLAIMANT IN OTHEWCOUNTIES ---t 'f
County
kOME�S�iFEJtb!
Township
rl A
County
%
Township
I hereby certify the above statements are true, correct and complete.
VAL U E
nature oI#Aaimiiutt
4fM=
&dn
0111111IN
lg
r and SIC1, � s�,
Zn,,,M j Q-,,
q� (P (
Xjt_ �r
kASSESS0RUSEONLW,
= -,.;. TRUE -TAX
ASSESSED VALUE
`AT 1/60
kOME�S�iFEJtb!
-NON-RESIDENTIAL'-,� —
rl A
VALUE;
Z.
100% F T.TV
-.VALUE-
VAL U E
Land not exceeding 1 (one) acre immediately
surrounding residential improvements-
Other land
(2)
Total land (line 1 plus fine 2)
(3)
Dwelling
(4)
Residential improvements
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 5)
(7)
Total value (line 3 plus line 7)
(8)
I hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
' ---STANDARDMEDUCTION 'ALLOW AN CE '
ow 20 Pay 20 —
Lesser of 1/2 Homestead $
Valuation or $6,000
Signature of Auditor L) Date signed
• - STATE FORM 5354(RS 18-10) TREASURER FORM TS-IA
APPROVED BY STATE BOARD Or ACCOUNTS.? B - PRESCRIBED BY THE OFPARTME•T OF LOCAL DOVER\MEYTFIIAKF.IC 6.1.1-22$I
!� Gibson County Auditor INIPORTANT 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,
_ H 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
® FILED FA 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 only 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.
APR 191011 , PART 1: PROPERTY INFORMATION
` Taxpayer Name Location Address
C. . Voight, John W
GIBSON COUNTY AUDITOR 10322 S 675 E
ELBERFELD IN 47613
- 9036 1
ELBERFELD STATE BANK IIIIIIIII[II IIIIIII11111 CID!IIIIIiILImo_IF 111 11111 1111
ATT: JOSEPH MELHISER
PO BOX 38
ELBERFELD IN 47613-0038
11111111011111111111111111111111111111111111111111111111111111 State Parcel Number Legal Description
• — —26-20-32-300,000.380-001 /T-E SW-32-3 9 2:50 AC — -_ —0.10-
This form MUST be returned to County Auditor's office.
Please do NOT send this form back with your tax payment to the county treasurer.
--• i--_..---..__-----------______PA RI.2.;.GTAXI'S)(ER INFOR FORMATION
First Middle Last
ir'eVA .- 19Hrvf VU 1 GNP
Mailing Address(number and street city,state,and ZIP code) ,/Same as property address
/0 35 2- S (9 )57-r n (.-:L t2�Q,1P =CAI Li 7 G,7J
Spouse First! Middle Last
Ali I
—
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
I I I I I I I I State
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 ignature Date -
PART 4: ADDITIONAL INFORMATION
•