Homestead_WhiteCLAIM FOR HOMESTEAD PROPERTY TAX FORM
i CREDIT /STANDARD DEDUCTION HC10
S i State Form 5473 (11215 -92)
INSTRUCTIONS: See reverse side for filing instructions.
I.N
- .CERTtRC ION STAT EMENT•`
YEA
if
I (We) certify that on the 1st Pay, of Ivjarc„ t1, JjN-
Ve) red as our princip place of residence the follWIndesJibad real property for which a Homestead Property /Tax�Credit is hereby claimed:
I (We) owned ❑ Are buying under contract yr'' -
❑ Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or i l66 rpg' under;a;contractTO:
_ CONTRACT RECORDED. _ ••�t - It buying on contract, Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
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PROPERTY DESCRIPTION
County
Township
Taxing district (
a r
Legal description
It 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.
BY CLAIMANT IN OTHER COUNTIES
Township
Pereby certify the above statements are true, correct and complete.
Address (number and street, city, state, ZIP code)
. ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON-RESIDENTIAL.
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
,
- "-
Otherland
(2)
Total land (line 1 plus line 2)
(3)
Residential improvements
Dwelling
(4)
-
Garage
(5)
'
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
complete.
Signature of Assessor
Date signed
verifying action - Signature of Auditor Date signed
STANDARD DEDUCTIONALLOWANCE- " -`
19 _Pay 19_
Lesser of 112 Homestead
Valuation or $2,000
$
Signature of Auditor
Date signed
STATE FORM!Mg I(_'!}Oi WASUILER FORM MIA
.srmoviO BY SINE aOARDrFMflRITS.wit PRC%Rmmnv 11R DEPARTMENT OF REAL OOVSSR.VMFNT FINANCE ICH.ISb4.I
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 ever for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
®
HEA 1344-21)09 requires mspavers who receive the homestead standard deduction to verify that they are eligible to remise the
benefit and to panicle additional identifvine information necessary to allow county government to better monitor homestead
filing.This information will he kept confidential and on only he accessed by authorized county officials.The Ikpannmi of
Local Government Finance will use this information to create tools that will help county official.eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
White, George L/ Mary J 73 g9 r cO
Francisco IN 47649
3237
George L/Mary J White
7389 E 450 S State Parcel Number Lezal Description
Francisco IN 47649-9164
Itlltllrrrll1111111111rIr111111rIr111111t11r111rr111tlrrlrllrl 26-20-05-2000-0 001.739-001 001-01739-00 PT NE NE 53930.00 AC
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.
PART 2:TAXPAYER INFOR%IATIQV
Owner I First Middle Last
Geo rAge 9G✓fr nice Z
�neAddress(number and street.city,state,and ZIP code) —T-� [R-Same as property address
73 CJ / F 505 FrcthGISGa Jrti Q76y
Spouse First Middle Last
Yha/0y 1—oetifu 60h /c
Mailing Address(Number and street,city,state,and ZIP code) 12-Same as property address
7389 Y505 Francisco
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PART 3:CERTIFICATION
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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
unlawfillly,he or she may be liable for back taxes and substantial financial penalties.