Homestead_Collins SIME FORM 11!YCIM!!„iMl TREASUILX FO&M 13-IA
.Arra[nED ac snit a(MROor MTrt:Tc.Yxw PRISM/1M BY till DEPARnNFYr(F LOCAL C1wZLNMrA7 FINANCE MH.1- -LI
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N Main
\ PRINCETON IN 47670 Individuals and married couples are limited to one homestead sandani deduction.As the receipt of this deduction becomes
,. more beneficial.there is more incentive than ner for homestead fraud.Homestead fraud causes higher tax bills for all;therefore.
HEA 1:44-'1009 requires taspaycrs who teethe the homestead standard deduction to verity that they are eligible to=else the
benefit and to provide additional identifying inform:mon necessary to allow county government to better monitor homestead
flings.This information will be kept confidential and can only be accessed by authorized county officials.The l)e anntent of
Local Gvvenuncnt Finance w ill use this information to create tools that will help county officiat,eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Collins, Mark E/Pamela J
a 38i1 E Ins
Francisco IN 47649
4063
Mark E/Pamela J Collins
3811 E Co Rd 175 S State Parcel Number Legal Description
Francisco IN 47649
26-12-23-100-000.801-004 002-00801-00- PTE NW 23 210 .60 AC
I x
PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
/nork Cdi,Jard C'oII/�s
1110,8 Address(number and street,city,state,and ZIP code) - - - ——— - __gSoine aZproperty address - - - - --
3811 E ()n . ` d 175- C Crancrsee =A/ 4/ 7loLi9
Spouse nn First Middle Last
# me1Q So e_ni );r6
Mailing Address(Number and street,city,sale,and ZIP code) ('Same as property address
3?/ I C &. 'mod 175s.
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_claimine,additional.homestead deductions
unlawfully,he or she may be liable for back taxes and substantial financial penalties.
Owner I .i':turn
Date
e� g CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
' State Form 5473(R2/5-92)
INSTRUCTIONS: See reverse side for filing instructions.
FORM ppYEAR
HC70
�; T�,i %Ey' hat on thet do r,o, f Ma.tCh, 19_
,.Je occupied as our principal place of residence the following described real property for which a Horn rope�v ft"Rssoneerreby claimed:
I (We) owned ❑ Are buying under contract - tiiVV VV
❑ 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
•Toxin 'trio (City, towntownship) .
@a c� nu ber
Legal de .- n
If 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.
(2)
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES '
County
Township
County
Township
Thereby certify the above statements are true, correct and complete.
Signatu of claimant
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)
Valuation or $2,000
-
Otherland
(2)
Total land (line I plus line 2))
(3)
Residential improvements
Dwelling
(4)
Garage
(6)
Other improvements
(6)
-
-
Total improvements (line 4 through line 6)
(7)
Total value (line 3 ptis line 7)
(g)
1 hereby certify the above is true, correct, and
Signature of Assessor _
Date signed
�in-rpleteg ac. tion - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19_Pay 19_
Lesser of 112 Homestead
$
Valuation or $2,000
Sig lure f Auditor — Date signed
=mot