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Homestead_Johnson (3) a STATE FORM •MI TCLAStIFA FORV,-]-IA APPROVED By SIAM.NNW OF .T!.vv PVAWBED BY TIE DEPARTMENT OF LOCAL IXn2@M11,T MPANCE MH.1-L`4.1 101 N Main County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS 101 N Main 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 ever for homestead fraud.Homestead fraud causes higher vas bills for all:therefore. HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verily that they are eligible to teethe the benefit and to provide additional identifying information necessary to allow county government to better monitor homestead filing.This information will be kept conlidenlial and can only be accessed by authorized county officials.The Depannml of Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud. PART 1: PROPERTY INFORMATION Taxpayer Name Pro r err ddress Johnson, William J/Penny M RI box 132 '/ Francisco IN 47649 V 3454 S- �93 Willilam J/Penny M Johnson j-05-7) R1 Box 132 State Parcel Number Legal-Description Francisco IN 47649-9210 26-12-12-400-000.33004 i7�D f PT 9E ta2- 1t1rt11rrr1r11rrr1rllFlnirlrrlriIrrlillrrlrirrliIr11rrl C- o PART 2:TAXPAYER INFORMATION Owner I First Middle Last 1c a 5 co a /I/'v5 c tg Address(number and street,city,state,and ZIP code) —-- - - rce as property address - • 2 3S - 556 = FXdVcl3cd i' . y7iV7 Spouse �� //) First Middle Last Mailing Address(Number and street,city,state.and ZIP code) ❑ Same as property address Social Security Number(last 5 digits) Drivers License/State ID Number (last 5 digits) Other(please specify in Pan 4 below) sow 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 Date r. dam^ 4 CLAIM FOR HOMESTEAD PROPERTY TAX YEAR y ' CREDIT /STANDARD DEDUCTION �H1 ti State Form 5473 (R2/1 -90) INSTRUCTIONS: See reverse side for filing instructions. OCT 2 6.1992 ��pp CERTIFICATION STATEMENT f� n I (We)!(y(lQvw� `� certify that on. the 1st day �4TRR19 -(We) occupied as our principal pla(g of sidence the following described real property for which a Homestead roperty Tax Credit is hereby claimed .: �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 it under a contract. CONTRACT RECORDED If buying on contract. Fee Simple Owner's Name _ Recorder's office where contract is recorded , Record Number Page i PROPERTY DESCRIPTION County Townsh Taxin istrict (Cit , town, township) Parcel Number Legal s 'pfi �� a- - If 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 r ASSESSOR USE ONLY TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON - RESIDENTIAL VALUE Land not exceeding 1 (one) acre immediately surrounding residential improvements Other land Total land - line (1) plus line (2) Residential improvements - Dwelling Garage Other improvements Total improvements - line (4) through line (6) Total value - line (3) plus line (7) - (1) 1991 Pay 1992 19 —Pay 19 — D1989 esser of 1/2 Homestead (2) Lesser of 112 Homestead Lesser of 1/2 Homestead Valuation or $2,500 (3) Valuation or $1,500 Valuation or $1,500 (4) - - - - - - - -- - - - (5) o- - (6) (7) (8) 1 hereby certify the above is true, correct, and complete Signature of Assesor Date Signed Verifying Action - Signature of Auditor Date Signed STANDARD DEDUCTION ALLOWANCE Pay 1990 1990 Pay 1991 1991 Pay 1992 19 —Pay 19 — D1989 esser of 1/2 Homestead Lesser of 112 Homestead Lesser of 112 Homestead Lesser of 1/2 Homestead Valuation or $2,500 Valuation or $2.000 Valuation or $1,500 Valuation or $1,500 Signature of Auditor Z. Date Signed o- - 11