Homestead_Elliott (3) xlwr FOFM!l'M la:0.4Pn T lAttUEA EOIN 73-IA
APPMNEO BY aUEnMRDot MlLNTf.Al. PVWWnfnaY nIEOEPARTcr OF LOCAL GOVERNS,rT k'EW 41.11:4I
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples arc limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial,there is more incenme than eser for homestead fraud.Homestead fraud causes higher tax bills for all;therefore.
HEA I344-2000 requires taxpayers 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.This information will he kept conlidenlial and can only he accessed by authorized county officials.The Ikpartmenl of
Local Government Finance will use this information to create mVls that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Elliott, William/Sheree L
R2 Box ISS /17</CsTiY?
Haubstadt 1
3406
William/Sheree L� Ellio tt, _ se R2- //q/~ � a State Parcel Number Legal Description
IN Haubstadt IN 47639-8031
111111IIlllliltllllllllittlIIlllI llltttllllll,Ilttltllltl 26-23-05-400-000.504-024 004-00504-00 PT E 54101.08 AC
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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 INFORMATION
Owner I First Middle Last
•te Address(number and street.city.state,and ZIP code) Same as property address
/49 Se 0g. gdaf Wt _2-712 V>eY
Spouse First Middle Last
Sie9/ee lee E//67171—
Mailing Address(Number and street.city,state,and ZIP code) El Same as property address
7/9q E St Gf /i9ais/at 7-4! V7� r3 l)
( _. - '
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.
pw>Kr 1,$ ��/ , Date
0
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e.�-''"R � CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
i��� CREDITISTANDARD DEDUCTION HC�o �
.�;��'�� State Form 5473 (R2/5-92)
�ei�
INSTRUCTIONS: See reverse side7aliling instructions.
�"Ne) _I 1 I�JVIJ,/ I Y� - I�(�'IXJIX.JL� � j[�"-� � � certify that on ihe 151 day of March, 19_
��/.) oc� p as our principal place of residence the following described real property for which a Homestead Property Tau Credit is hereby daimed:
CJ I(We) owned ❑ Are buying under coniract .
❑ Have a beneficial interest in the entiry ihat is liable for the property taxes on the property and that owns ihe proper���:�ande�-e�:��
If brying on contract, Fee Simple owner's name
Recortler's oNice where contraa is recortled
Coumy TownShip
PROPERTY
RECORDED
Taxing
(Pa, n e^ ] �/1 �(" /�� /� �Legaldescriptio�� —Q� , /O I� � / D� /
I 1"l �11 1 V �y _ S!! �. !y
UV�J U-e/ i G1( / f� �- /
li any portion of the resitlential stmcmre or the land not exceedinq one (1) ave that immetliatety surrounds that stmcWre is used to produce income, descrihe the use and portion
ot Ne property utiiized ro produce income. .
PROPEHTY OWNED BY CLAIMANT IN OTHER COUNTIES
Counry _ owns ip
�eby certify the above statemenis are ime, correci and complete. Signamre iaimam
'Address (numberandslreeC ciry, state, ZlPcode)
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ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
.VALUE VALUE VAWE VALUE
Land not exceeding 1(one) acre immediately
surrounding resideniial improvemenis. (�)
Otherland (2) �
Total land (line 1 plus line 2� (3) '
Dwelling (4)
Residential improvemenis .
Garage (g)
Oiherimprovemenis (6)
Total impmvements (line 4 through lina � (7�
To�al value (line 3 p�s line � (g) I .
I hereby certify the above is irue. correct, and Signamre of Assessor Date signed
complete. �
����tying action - SgnaWre of Audiror Dare signed
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19_Pay19_
Lesser of t/2 Homestead
Valuation or 52.000
STANDARD DEDUCTION
S
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SgnaWre ol Audi:or u� Date signetl