Homestead_Allen (7)..<n•R CLAIM FOR HOMESTEAD PROPERTY TAX
�� ;4; CREDIT/STANDARD DEDUCTION
•;.,�� State Form 5473 (R2/1-90) �
JNSTRUCTIONS: See reverse side (or filing instructions. _
_,
TION STATEMENT
FORM YEAR
HC10 �.
.V
�. }����..:�./tit�,,.�:�;,.�. ����^D �
M" (We;' T � _ __ __._�ertify that on t a r 19 �
I(We) occupied as our principal place �i residence the follo ing described reai property for which a Homestead
,�p y R qt
Property Tax Credit is hereby claimed: I(We) owned L'JAAr� �'u�tf g'under contract
� Have a beneficial interest in ihe entity that is liable for the property taxes the p�er�.�r yJ,Sl�iat owns the
property or is buying it under a contract. AUDITOR� �
on contract. Fee Simple Owner's Name
Recorder's ofiice where contract is
RECORUED
PROPERTY DESCRIPTION •
_hi���/ �J Taxing District (City, town, township)
�.l,o lf'a _ .'L�r//. .
Parcel Number Le al Descripiion U
�U�- �a.no6-on ��� �-� -/D .9a�a6 �c�•
Ii any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that struc-
ture is used to produce income describe the use and portion of the property utilized to.produce income.
PROPERTY OWNED BY CLAIMANT IN�OTHER COUNTIES
^ounty Township Couniy . , Township
I hereby certify the above statemenis are true, correct and .. �- � Si nature , �
complete.
Address (Streei, number, city, state and ZIP code)
ASSESSOR USE ONLY , TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL
' vnwe
Land not exceeding 1(one) acre immediately � '
surrounding residential improvemenis (�)
Otherland (2)
Total land - line (1) plus line (2) (3)
Residential improvements Dwelling -- (4) - - - - � - - - � �- - -
Garage (5)
Oiher improvements (6)
Total improvemenis - line (4) ihrough line (6) (7)
Total value - line (3) plus line (7) (8)
I hereby certify the above is true, Signature of Assesor Date Signed
correct, and complete
Verifying Action - Signature of Auditor Date Signed
7 989 Pay 7 990
Lesser of 7/2 Homestead
Valuation or $2,500
STANDARD DEDUCTION ALLOWANCE
1990 Pay 7 991 1991 Pay 1992 19 — Pay 7 9—
Lesser of 7/2 Homestead Lesser of 1/2 Homestead Lesser of 7/2 Homestead
Valuation or $2.000 Valuation or S1,500 Valuation or $1,500
Signature of Auditor � Date
STATE FOR\f 51569 (IUlB-10)
APPROt'ED BY SfAIE BONtD OF ACCOU�TS, 2009
f RFASURFR FOR.N T$-IA
PRESCRIBED BY 1}[E DFPA0.P¢�T OF LOCAL CAYER�TIEM FI�A�CE ICbl.l ::-B.1
Individuals and married couples are limited to one homestead standard deduction. As the receipt of this
�� duction becomes more beneficial, there is more iucentive than ever for homestead fraud. Homestead_fraud
causes higher tax bills for all; t6erefore, HEA 1344-2009 requires taxpayers ���ho receive the homestead
standard deduction to verify that they are eligible to receive the benefit and to pro��ide additional identifying
information necessary to allow county governmenf to better monitor homestead filings. This information
«�ill be kept confidential and can only be accessed by authorized county officials. The Department of Local
Governuient Finance will use this informatiou to create tools that will help county officials eliminate
homestead fraud.
' � ' � ' � `?;"''."��:;;':;
Taaoerer \1me pronerfv Addrns $tate Partel \umber Leeal Dncrimion:
Harrison K/ Marianne Allen 1346 N SR 65 26-12-06-100-002.006-027 PT NE 6 2 10 .9?60 AC
PRINCEI'ON M 47670 p_�
Complete and retrun to: - I�II���C�L�D�E�I�GL��I��I�Ir.tIII111�116imn�:iEi��i�i��
CIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
1 �
Owner 1 Fvs� Mbtlia Last
}%r r i so r� ��e���i �1 /%n
MaiW+g naaress (mmDer eeW sveal ary, atate ana ZIP coae) (��Seme as propeny aaaress
� ��
Sodal Secvnry NumDer (lut 5 diBiu) Orrve(s LironvlStx.e ID NunEer (lut S Elplts) �pe �� (W� specily in oart a belv.v)
_� �
Spwse First MiECIe last
�r�anne �i I��n .
Madvp AtlOreu (n�mDe� aM svee� ary, sWte arW ZIP m0e) Same as yopeM1y edCress
��
Sadal Seamry Niaroer (last 5 Eigits) Drivera Liunsaf5tate ID NimEer Qast 5 EIpl4) � Oltim (Wease speNy in Pan a beWw�
�� .�N
,,
Each undersigned certifies, under penalty of perjury, that the above and toregoing information is true and correct and thai he or she is eligible to receive the
homestead standard deduction on this property. Each undersigned also understands that, by Gaiming additional homestead deductions unlawfully, he or
she may be liable for back laxes and substantial financial penalties.
Pxmt 1 Si{pfatwe Daro Telapta�a
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