Homestead_Coleman STATE FORM AMA.(IC Au, TREASURIR RAN 75-IA
\Plgr.'En BY Crxaf bNFDDr'.MV'tlti Tt.gr PaF_`l[111pQIpY T1EpEPAR1M6Yr Or LOCAL CAWEILVMCA'L iTA\YEm•l.l-2_-!1
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 e'er for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
• HEA 134:-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to recehe the
benefit and to provide additional identifying information neces n'to allow county •cwernment to better monitor homestead
hlintn.This information will he kept confidential and can only be accessed by authorized county officials.The Depannrent of
Local Government Finance"ill me this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Coleman, Barbara Trust
R2 l3ox 338
2118
Coleman Barbara Trust
4744 E 100 N State Parcel Number Legal Description
Princeton IN 47670-8945
1r1u11u t1t11n�nr111tn1u1r1r1ut1n1.1t1ulnit�niu ltll 26-12-01-100-000.595-004 002-00595-00 PT E NW 1-2-101 AC
C-1 D-7
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
s Address(nunst r raid strxt,eiry,rata;and'ZIP code) — -— - —u-Surne es property addrs: -— _—- - .
, /E74 4 /COM Pz 517670 Pmo , e. on -
• • 4// 7e
Spouse First Middle Last
Mailing Address(Number and steel,city,state,and ZIP code) ❑Same as propeny address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
5D¢
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 Signature �{,,�� y ,L ,erya(Q.([c. Date
CLAIM FOR HOMESTEAD PROPERTY TAX - 11' T L_q ' - R
i CREDIT /STANDARD DEDUCTION ( H
State Form 5473 (R2 / 5 -92) JUN 16 A.
raa
INSTRUCTIONS: See reverse side for filing nstructions.
g Fy).
rcoTlcrr AT?MM CTAT=U=C — — - .._.___
rvye) f0aAAhaAQ (A—&/r0Q/x_AjUA4± certify that on the 1st day of March. 19
0r
I�) occupied as our principal place of residence the following described real property for which a Homestead Property Tax Credit is hereby claimed:
%N I (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 OWNED BY CLAIMANT IN OTHER COUNTIES
` PROPERTY DESCRIPTION
County
County
Township
Taxing district (city, town, township)
Parc I number
Oo - 5-o
Legal description
E
If any portion of the residential structure or the land not exceeding one (1) acre that immediatety surrounds that structure is used to produce income, describe the use and portion
of the property utilized to produce income.
Otherland
(2)
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
Townshp
County
Township
teby certify the above statements are true, correct and complete.
ture of claimant
J
A ss (number and street, city, state, ZIP code)
Z
ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON- RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
luatio7!!0
-
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 pHs line 7)
(6)
I hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
®tying action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19_Pay 19_
Lesser of 1/2 Homestead
$
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nature of Auditor / -
Signature
Date signe /I,�
1