Homestead_Andres MIN 73-1A
STATE corm Y!W 12'/•MI iRrealwrr fro-r4
APPROVED BY ai\TE MVOM.YYY�I TI tier, 111900131!D BY nlr nEPM1�rFLQ`.LLf�0.4v.G'r Vp:t\YEN'VI.V-1'J.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and hurried couples are limited to or homestead reandard 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 1344-2009 requires taxpners who receive the homestead standard deduction to verify that they are eligible to reecho the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.'Ibis information will be kept contidrntial and can only he accessed by authorized county oficiah:.The Department 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
_ Andres, Sharon M
6273 1:350 S
Francisco IN 47649
4835
Sharon M Andres
6273E 350 S State Parcel Number Legal Description
FRANCISCO IN 47649-9108
1I1Il11trr1r11r trlt rlltirtirltrrrr1111llu Ill111llrll lllIlr�tll 26-13-31-200-000.752-004 002-00752-00 PT NE NE 31-2-9 5AC
D-10
PART 2: TAXPAYER 1NFORMATION
Owner I First Middle Last
fg Address(number and sweet s city,state,and ZIP code) -- - - - — Same as property eddies .
— - - -
6 l3 e 35-os FRAKRCL3CO Z)3 , N 'I b u q
Spouse First /A Middle Last
NARK-1 rt AUDIRGs
Mailing Address(Number and street,city,state,and ZIP code) ❑ Saute as property address
422-'z5 &5 o5 rR 9Y1,ts T.U, ti 'Z A y `i
Each undersigned certifies,under penalty of perjury,that the above and foregoing infonnation 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.
'net I Signatures Date
•
•
CLAIM ;FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDIT /STANDARD DEDUCTION
State Form 5473 (R614-03) TA
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for riling instructions.
C C IF R T tnrtm n m q TATF U F: N T it F I I
'Is. X -'. 2L'--� 1111' "", r Iff4
I (We) IWLC) r \, v /I certify thojNthq 16 d�085March, 20
1(We) occupied as our principal place of residence the following described real pro d Property Tax Credit is hereby claimed:
I (We) owned ❑ Are buying under contract
ave a beneficial interest in the entity that is liable for the property taxes on the property and that owns the
,�,,ro e 7s �bu)ntnnder a contract.
is GI
GIBS ON AUDITOR
-�S; tZ-- RACTRECORDED",'
If buying on contract, Fee Simple owners name
Reo:xclees office where contract is recorded Record number Page
-R OPERTY DESCRIPTION tt--4,�
County
Township
Taxing district (ciry, town, toThf"—,�
Si n I claims
Pa
Legal description
Is the pro
Valuation or 535,000
ja
al 1 PPny ❑ Mobile Home (I.C. 6-1.1-7)
If any portion of the residential structure or the land not exceeding we (1) am that immediately surrounds that structure is used to produce income, describe the use and portion
of the property utilized to produce income.
1:=1rffcZ� PRdPER77,Y�'(jWNED,BY,�'dL�MMkNT-,IN'OTHER�,-cbUNTIESi4Et-4�4_---i4�i- ��4T
County Township
County Township
I hereby certify the above statements are true, correct and complete.
Si n I claims
A
J., q-76 c[9
jY-,@4!PV '-4,qjV,�'`•>'Z *kA$STANDARD, DEDUCTIOWALLOWAINCE-i-, •
--A TRUE TAkw!t2
ASSESSED.
kdIAE STEADV
�t�NONAESIDENTIAO
Lesser of 1/2 Homestead
Valuation or 535,000
91297
Sign dity
Land not exceeding 1 (one) acre immediately
Date s*P'W
M- /S-C9'
surrounding residential Improvements.
Other land
(2)
Total land (line I plus line 2)
(3)
Dwelling
(4)
Residential improvements or Annually
0
Assessed Mobile I Manufactured Home
Garage
(5)
t improvements
(6)
N i4
Total Improvements (fine 4 through line 6)
(7)
Total value (line 3 plus line 7)
(8)
1 hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
jY-,@4!PV '-4,qjV,�'`•>'Z *kA$STANDARD, DEDUCTIOWALLOWAINCE-i-, •
MW 20_Pay20_
Lesser of 1/2 Homestead
Valuation or 535,000
91297
Sign dity
Date s*P'W
M- /S-C9'