Homestead_Edwards SIAM FORM!I'M IR_1..rv1 MASIIRER FORM 711A
&MIMED BY MAIL NAM)of MTTtLNTS.p/n Plr911.1nrDaT VIM DEPARTKEYr OF LOCAL fi m....Mren FINANCE 1e ,.l_tI
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 incentne than cser for homestead fraud.Homestead fraud causes higher tat bills for all:therefore.
• HFA 13-14--3IX9 requires uspayers who remise the homestead standard deduction to verify that they are eligible to teethe the
benefit and to provide additional identifying mformatmn nemary to allow county government to bean'monitor honesead
filings.This information will be kept confidential and can only to accessed by authorized count'officials.The Ikpannent of
Local Government Finance will me this information to areate tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Edwards, Dewayne C/Laura M 6 1
JL RI Hose I10
n,6 /6 1) Oakland City IN 47660
4795 U.A q
Dewayne C/Laura M Edwards
2525 S 850E State Parcel Numb r Legal Description
Oakland City IN 47660-8505
III I I I I I I IIII I I 26-13-28-200-000.584-004 002-00584-00 N NE NE 28-2-9 20 AC
at u
r t r nr a nr u rt r r uu r nr r II r t II nr I r II C-1 D-6
PART 2: TAXPAYER INFORMATION .
Owner I First Middle � Last
I - . e e,f err(�)_.
tg Address umber and street,city,state,and ZIP code) —- — — Mc Its property address--—— —61.5 as S , S E . Oc.•KtiA-i‘cd Cu)-t om At, -1 L LO D
Spouse First Middle Last
C R- a r iA 1 EA, Lia if` (-,Q s
Mailing Address(Number and street,city,state,and ZIP code) 9 Same as property address
_S-a-s S , <& & L Ci R / 0° C.`k 11-1A1 £f l LL Lp o
I PART 3:CERTIFICATION i
Each undersigned certifies,under penalty of perjury,that the above and foregoing inforrnation 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 ]- .tore
�7 iUate
PART 4:ADDITIONAL INFORMATION
. e
CLAIM FOR HOMESTEAD PROPERTY TAX FORM PEAR
CREDIT /STANDARD DEDUCTION Hcto
State Form 5473 (R614-03)
Prescribed by the Department of Loced Wvemmmtt Firarce
INSTRUCTIONS: See reverse sidle for 015V kw&Lcdons.
I (we) C ' V ( Y 9AAAoO%-4 -f I t-InILU RNA.4Mc�certif I loth; 1st
r pnncfpAlace of residence the following described real property for which a Homestearrop
I (We) occupied as o' Tia, of ,
❑ 1 (We) owned ❑ Are buying under contract M
R. 0 1)
Wk Have a beneficial interest in the entity that is liable for the property taxes on the property and that owms the prope or trying under a contract.
If buying on contract, Fee Simple owners name
where contract is recorded
Record number I Page
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�P.ROPERTY<DESCRIPTIONz?-�-- V
County
Township
I hereby certify the above statements are true, correct and complete.
Taxing district (city, town, township)
ATnu dry, rstare, acis)
ILnln*l
UE'
Land not exceeding 1 (one) acre immediately
Is the property in question:
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Date
tm
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El Real property ❑ Mobile Home (LC. 61.1-7)
If any portion of the residential structure or the land not
exceeding we (1) acre that immediately surrounds that structure is used to produce Income, describe the use and portion
of the property utirLud to prod" income.
(2)
(906C
"?o 0 0
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County
Township
County Tavnship
I hereby certify the above statements are true, correct and complete.
Signature of claimant
ATnu dry, rstare, acis)
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20— Pay 2O— —Fs
HOMESTEAD
�YR sic
'.`4NON41ESIDENTIAL
Valuation or S35.000
UE'
Land not exceeding 1 (one) acre immediately
[3
Date
surrounding residential improvements.
Other land
(2)
Total land (line I plus line 2)
(3)
'Residential
Dwelling
(4)
Improvements or Annually
Assessed Mobile I Manufactured HOMO
Garage
(5)
iC44"5 W%
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (fine 3 plus line 7)
(8)
I hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying; action - Signature of Auditor
Date signed
�=ISTANC�ARb.DEDUCTION;ALLOWANCE: ti�- �- 4.,s
20— Pay 2O— —Fs
Lesser of 1/2 Homestead
Valuation or S35.000
Signature of Auditor
[3
Date