Homestead_BaughnCLAIM FOR HOMESTEAD PROPERTY TAX F R
CREDIT /STANDARD DEDUCTION
Stale Form 5473(R8 I7 -07) , \,(��` HC10
Prescribed by the Department of Loral Government Finance { jHN 2 200
CER INSTRUCTIONS: See reve�rs/e� side for filing instruction.]
I (We) W � •
s. certify that on the 1 st day of March, 20_
I (We) occupied as our principal place of residence the follo ' described real property for which a Homestead Property Tax Credit is hereby daimed:
r] 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.
CONTRACTRECORDED
If buying on contras , Fee simple owners name
Recorders office where contract is recorded Record number Page
County
Township
I hereby certify the above statements are true, correct and complete.
and street.
County
Of
ASSESSOR USE ONLY
Coun
PROPERTY DESCRIPTION
Towmship
Taxing district (city. town, tonmshj )
^y —bon:
Pa umber
Legal description
-� S
VALUE
Is the property in
I property ❑ Mobile Home (IC 6- 1.1 -7)
If arty portion o! the residential structure or the land not exceeding one (1) acre that immediately suneunds that re is used to produce income, describe the use and portion
of the property utilized to produce income.
County
Township
I hereby certify the above statements are true, correct and complete.
and street.
County
Of
ASSESSOR USE ONLY
• r
AT, 100% OF TTV
VALUE
VALUE
Land not exceeding 1 (one) acre immediately
- .:'.•- -.� >; - -. ` ;- � .. -:
surrounding residential improvements.
..
Other lard
(2)
_ ,-
Trial land (line 1 plus lime 2)
(3)
Residentialimprovements or Annually
Dwelling
(4)
:c. a,,;x ^'r•ar.- r <,a -: =: `::- ....-t
Assessed Mobile I Manufactured Home
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through 6ne 6)
(7)
Total value (line 3 plus line 7)
(g)
I hereby certify the above is true, coned, and
Signature of Assessor
Date signed (month, da)4 year)
complete.
Verifying adion - Signature of Auditor
Date signed (month, day, year)
IF— Pay 20 45,000 for 2007 pay 2008 42,000 for 2010 pay 2011
Lesser e of ad Valuat
ffi 44,000 for 2008 pay 2009 41,000 for 2011 pay 2012
Homestead on $
or 43,000 for 2009 pay 2010 40,000 payable after 2012
• ctATE FOxM!I!vw IC/c4Ml TRFASUILR FOAM IS-IA
l .A PPWT'EO BY SIRTL BO SRDrWMrrt ENTS.9r, PRESCRIBED BY TIE DEPART\I[YT OF I AI COVEIO1FA'T FDs&s'CE IC4I.Ir A.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 ever for homestead fraud.Homestead fraud causes higher tat bills for all:therefore.
HEA 1344-2004 requires taxpayert who receive the homestead standard deduction to verity that they am eligible to receive the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will he kepi confidential and can only be accessed by authorized county officials.The IXpanntent of
Local Government Finance will use this information to create 4x is that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Baughn, Richard MNirginia D Wolfe
211 S Division
Francisco IN 47b-19-_--——
4539
Richard M Baughn
PO Box 176 State Parcel Number Legal Description
FRANCISCO IN 47649-0176
I t I t t l l t t E l t l l t t t I r t I I r I t t�� I I I...I.I I t,I t t r�t I I t t t r I I � 26-13-19-204-000.015-005 012-00015-00 PT SE NE 1929 1.10 AC
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
- ; c 6-14 IJ t{-J 6-0 I�
"kg Address(number and street,city,state,and ZIP code) - - - — ❑ Same as property oddics --- — - - - — - -
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
sax
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��Signature Date
PART 4:ADDITIONAL INFORMATION
•
J