Homestead_Julian (3) STATE MINI535..in/Wel MANILA Po0.4 73-1A
APPROVED ItY SPATEM1Ro OF A/TTL:TS.n,s PEIYAIarD BY nlr DEPARTMENT(FLOCAL GOVERN'MrWT ra\A'CE MLI.I-r`-LI
Gibson bounty Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead standanl deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than e'er for homestead fraud.homestead fraud causes higher tax bills for all:therefore.
• HEA 134-4-2009 requires taxpayers who receive the homestead standard deduction to verify that they arc eligible to receive the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filintta.This inhumation will be kept coati-mtiol and can only he accessed b), authorized county officials.The Depanmcm of
Local Government Finance will use this information to erea:c tools that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION
Taxpayer Name Property Address
Julian, Kimberly M
RI host 342n
Ilaubstadt IN 47639
3365
Kimberly M Julian
857 W 1200 S State Parcel Number Le2a1 Description
HAUBSTADT IN 47639-8725
It Ittlltttltllttttlltltlrtltt ltltttltt ltd tltlt tltlrlt ttllt till 26-22-13-200-001.425-024 004-01425-00 PT NE 13411 1AC
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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
kliimberly Mcchellc- Jilt ian
lipa e Address(number and street.city,state,and ZIP code) Same as property address
657 W1 I a_00 S N CLO-6S4—act-+- , I ►\1 47639
Spouse First Middle Last
Mailing Address(Number and street city,state,and ZIP code) 0 Same as property address
Social Security Number(last 5 digits) Drivers License/Stare ID Number (last 5 digits) Other(please specify in Part 4 below)
. _ . _-._ shit_ _
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
I
� :.,.E a
e �� CREDIT/STA DARDTD DUCT ON RTY TAX
• �i� Siate Form 5473 (R2 / 5-92)
�:=''
fi INSTRUCTIONS: See ieverse side !or filing instructions.
FORM YEAR
- HL''1� � -;�4";
� `` � �
� CERTIFICATION T EME "
�✓e) �niry that on tlie 1st day ot MarcF��t9_
�: �,c
I(VJe) occ pi al place of residence the following de ibed real ro erty for which a Home�!@ad-Pruperty Tax CrediKiS e�v�elaimed:
❑ 1(VJe) ned ❑ Are buying under contract �° GIBSCA� C:::?�d i Y AUDITOis ! .
❑ Have a beneficial interest in the entity that is liable tor the property taxes on the property and that owns ihe property or is buying under a coniract.
CONTRACT RECORDED
If buying on contract. Fee Simple owners name
Recortlefs oHice where contract is recorded . . fiecord number Page
PROPERTY DESCRIPTION
Counry Township Taxing tlis�rict (city, fown, fownship)
Parcel n mber Legal tlescription 1 r'
-�9 0�-� `= - `T -" � ) � C.
I( any poNOn of Ne resitlential struc[ure or ihe tand rrot exceeding one ( 7 � acre that immetliatey surtountls thai structure is usetl to protluce income, describe the uu and portion ot
ihe property utilizetl ro produce income.
�� - - 3- - �s- a� -
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES �
Counry Township Counry Township
Si of cla. n)/ `
' tiereby certify the above statements are We, correct and complete. (�� �� �^
_�dress (number anC street ciry, slafe, ZIP code) '
a 3�fzn3 �cb� �- � �1�b3�j
ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not ezceeding i(one) acre immediately (� � �
surrounding residential improvemenis.
Otherland (2)
Total land (line 7 plus line 2) (3)
Dwelling (4)
Residential improvements
Garage (5)
Other improvements (6) .
Total improvements (line 4 through line 6J (7)
Total value (line 3 plus line 7) (8)
I hereby certify ihe above is Irue, correct, and Signawre ot Assesor Date signed
complete.
veritying acrion - Signamre of Auditw Date signed
� STANDARD DEDUCTION ALLOWANCE
79_ Pay 19 _
Lesser of V2 Homestead �
Valuation or 52,000
Signature ot Auditor Date signed
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