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Homestead_Burns ants FORM 5n.,1C/,4N1 iRF.11:[FII FORM 13-1A APFR EO BY STATE 9OnRDnE+RYRnTa.`m rte ,mmaY nn DEPARTMENTOF LDAL COVEEL''MR.T FEASCE MVI.I-La.l 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 1344-2000 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the benefit and to provide additional identifying_ information neces n'to allow county government to better monitor homestead filings.This information will he kept confidential and can only he accessed by authorized county ntliicials.the Department of Local Government Finance will um this information to create tools that will help county officials eliminate homestead fraud. PART 1: PROPERTY INFORMATION Taxpayer Name Property Address Burns, A Alan/Susan L R I Box 307 Francisco IN 47619 4831 l./ A Alan/Susan L Burns 3623 S 650 E State Parcel Number Legal Description Francisco IN 47649-9143 26-13-31-200-000.063-004 002-00063-00 PT NE NE 31-2-9 2.69 AC lilt'lltttltllrttlttlltlttlFltt tttllFlttittlilt'I.lttlltlttl11 D-10 PART 2:TAXPAYER INFORMATION Owner I First Middle Last -ANTI+only 4LAW Bt.kzA/s gig Address(number and street.city,state,and ZIP code) ® Same as property address -310 c .3 • /050 rva+J &fsco .Li) t7b19 Spouse First Middle Last Sus�h �yNrJ 3u26 Mailing Address(Number and street.city.state,and ZIP code) ® Same as property address 3 a3 6. 1050 e Ft�rnlc.,sc -2W 4/7641? Each undersigned certifies,under penalty of perjuy.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 i �a nxp - e� 4 CLAIM FOR HOMESTEAD PROPERTY TAX . CREDIT /STANDARD DEDUCTION State Form 5473 (R2 / 5 -92) reis INSTRUCTIONS: See reverse side for filing instructions. YEAR NOV 2 6 1996 I (We) l d ( g M R ,. _ � �� certify that on thAULabT @RI.4c6, -119 occupied as our principal place of residence the following described real property for which a Homestead Property Tax Credit is hereby claimed: (We) owned ❑ Are buying under contract Have 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. CONTRACT RECORDED ` - If buying on contract, Fee Simple owner's name . Recorder's office where contract is recorded Record number Page - `'. PROPERTY DESCRIPTION - - - County Township Township Taxin district (city, town, township) - - Parcel number Legal description - Otherland (2) It any portion o 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. Total land (line I plus line 2) PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES - County Township County Township by certify the above statements are true, correct and complete. .e Signature of Iaimanl Address (number and street, city, state, ZIP code) 3o I — c S :: 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 I 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) 1 hereby certify the above is true, correct, and complete. Signature of Assessor Date signed verifying action - Signature of Auditor IS Date signed I v STANDARD DEDUCTION ALLOWANCE 19 Pay 19_ Lesser of 112 Homestead Valuation or S2,000 S Date