Homestead_Miskell Stilt FOAM'SW.ai N-tm TR ASnasR PORN IS-IA
A/PRIKEnttl CINIE?OsRD or At I t*tr.._0t ?ttI.YRMko HI THE mfARTt!>l Or LOCM.60VtA>1-$1 Ir.AMtR'F:.1124.1
Gibson County Auditor IMPORTANT NOTICE-TO HOMESTEAD'PROPERTY OW ERS'
101 N.Main Street Individuals and married couples are limited to one homestead standard deduction.As the receipt ml this deduction becomes
Princeton, IN 47670
ga more beneficial.Owe,is more incentive than ever for homestead fraud.Homestead fraud causes higher tax bills for all:therefore,
HEA 13442009 requires taxpa■ers who receive the homestead standard deduction to terify that they are eligible to receive the
benefit and to provide additional identifying c f ing mti>mut can necessary y be to allow county government to bunter The monitor
Department homestead
filings.'this information will be kept eonfidviuial and can only be accessed by authorized county officials.The Department of
FILED Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION-
- MAY 14 2012 Taxpayer Name Location Address
Miskell, Matthew QS 1•f�C S+G so E
C.'J.N y
GIBSON COUNTY AUDITOR FRANCISCO IN 47649
4817
Matt ell IIIIIII111IIII hill mil IDIIIilllIDIIIIIIIIIIIo111hp hill 10IPhlI_�IIIII_II_IIII
FRANCISCO IN 47649-9058
'II�II11�1�11'II'I'�1'�IIII'II�II�"III��'lll'I'll�llllll�l'I'lll State Parcel Number Legal Description
26-13-29-101-001.623-004 PT NW NW 29 2 9 1.487 AC
17,z .S 65-0
0
This form MUST be returned to County Auditor's office.
Please do NOT send this form back with your tax payment to the county treasurer.
r . I •I 1 _
_r I First Middle Last o
k9,arTNE vv ?VAL/ Joss eE
Mailing Address(number and street city,stare,and ZIP code) ❑ Same as property address
Spouse First Middle Last
Mailing Address(Number and sleet,city,state,and ZIP code) [] Same as property address
Social Security Number(last 5 digits) Dtivefs License/State ID Number (las:5 digits) Other(please specify in Part 4 below)
I
I I I I see
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
CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDITISTANDARD DEDUCTION
State Form 5473 (R7 I 5-M fn
Prescrimd by the Deperbrent of Lo l Government Fka.rre
INSTRUCTIONS., Sea reverse side for Ring Instructions. T-1
I (We) 4 f `' r am* that 'Ldp.y=. 20-
I (We) occupied as our principal piece of residence the following descrbad real property for which a Homestead 1= t claimed:
I (We) owned [-I Are buyng under contract
Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the Wi uddier a contract.
�,
PGMIS No ; COU T n
AUDITOR
tONTRACTRECORDEDw
If buying on ordracl, Fee Simple owners narre
Pm=dws O6m Where contract is r ®bled Record number Page
PROYDESMFM(*,�' I ly? �4 A " e
1
TaNnstup
Taung dEstrict (CilY f"rn, towm4w)
Parcel rKffnbW
Lesser of 112 Hornestaad
Ls the pop" it quesbon:
I hereby oerbfy the above slaternents are true. correct and complete.
Signature of claffn2rit
MiAZ--1
❑ P.-d Ww-ty �iMobile Home (I.0 61.1-7)
if irry amm,t 1 wxb thW structure is used to pnxJum ir�, describe the use and pubm
-P-blal 2
or, =CZ= ffxxxne.
-00
�; , 111 1..."�1-11.1 �, 1,
�,"'�V^OROPBM 0MED'BY,&AWANT IWIDTHER COMIES I",
1
County
Township
County
Lesser of 112 Hornestaad
Township
I hereby oerbfy the above slaternents are true. correct and complete.
Signature of claffn2rit
MiAZ--1
VALUE
I
Valuation or $35.000
.1r25"72'5'7S72 7-r') FIANC-T5,--o-TAV
.....
.. . . . . .
ASSESSED VALUE
'!AT.,l*M
.,HOIWSTEAD
-NON-RESMEN
Lesser of 112 Hornestaad
VALUE
Land not exceeding 1 (one) acre mynediatety
Valuation or $35.000
M
surrounding residential improvers ents-
Date signed
Other land
(2)
TeW land (Ibm I plus fare 2)
(3)
Dwelling
(4)
Residential irnprovernents or Anntudly
Garage
(5)
Assessed Mobile I k4arrufactuilad Horne
9.
Other mprovennents
(6)
Trial snprovernards (Fm 4 ftrough Im M
Till value (Ise 3 plus #no 7)
(8)
I hereby car* the above is true, correct, and
cornPlete-
Signature of ftSessar
hate 80
Now" action - Sqnffture of Xmidor
Date s0md
20— Pay 20—
Lesser of 112 Hornestaad
$
Valuation or $35.000
Signature of Audhor
Date signed