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Homestead_Pond f - STATE PoPM5330(R0/8114 TFASLREA FOAM TS-IA
APPROVED BY STATE BOARD OF KCOUNTS 2 Q PBESCT®W BY THE DEPARTMENT OF LOCAL GovrmsMEYm FOANCE IC 61.1.334.1
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
/ 101 N. Main Street Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
Princeton, IN 47670 more beneficial,there is more incentive than ever for homestead fraud.Homestead fraud causes higher lax bills for all;therefore,
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they arc eligible to receive the
0 benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will be kept confidential and can only be accessed by authorized county officials.The Department of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
T. T T T'� PAKT 1: PROPERTY INFOILMMATION
_ •� ® 9 {� Taxpayer Name Location Address
g' 1 L L Pond, David L/Vicki L
APR 11 2011 1761 s 725 E
. FRANCISCO IN 47649
28 • C. .Nv
I Bit VIII DInIlliii ID I ti iii11111_111iii ivi 11
I DI _II I IDavid COUNTY AUDITOR
1761
Francisco IN 47649-9076
III'llllrllllllltllltlltlttIlt 1111'llI'II"'I' 'lllll'llllll"II' State Parcel Number Legal Description
26-13-20-200-000.167-004 PT NE 20 2 914.041 AC C-1 D-7
5
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.
0,. _. I First Middle
Ot✓'Oi cc_ Po h di
Mailing Address(number and street,city,state,and ZIP code) Cie as property address
/7` / S 72s g Francisco .it/ V2lYi
Spouse / First l Middle Last
Vic�Ir lrnrt hG1<
Mailing Address(Number and street.city,—stite.and ZIP nodal- -_ - —_ _ __ _. .I_oCmc aspropertyaddress_ -- ---.— - — .
— / 7CI S 72s F 5AAc;sco Z1" `V7(y1
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///liiiiable for back taxes and substantial financial penalties.
Owner I S ; t�L // Date Telephone
Si turn Date Telephone
Li.0-ft (812 ) 712 - 3(-2 /
PART 4: ADDITIONAL INFORMATION
.T•
414�3
CLAIM FOR HOMESTEAD PROPERTY TAX
l CREDIT /STANDARD DEDUCTION
f' State Form 5473 (R21592)
reTi
INSTRUCTIONS: See reverse side for filing instructions.
FORM YEAR
HC10 17q
U /LAAIF PJ 0•t__V Lf,4C. F(I T ( certify that on the 1st day of March, 19-P
I
occupied as our principal place of residence the following described real properly for which a Homestead Property Tax Credit is hereby claimed
❑ 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 ownsre or iMIT u er a contract.
- CONTRACT RECORDED MU -
It buying on contract, Fee Simple owner's name
Recorders office where contract is recorded 171061uftnq Page
PROPERTY DESCRIPTION
County - .
Township
Taxing district (city, town, township)
Parcel number
Legal description
O
Address (number and street, city, state, ZIP code)
_ —
If any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that structure is used to produce income, describe the use and portion
of the property utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County Township
County Township
®eby certify the above statements are true, correct and complete.
ign ure of c
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Address (number and street, city, state, ZIP code)
ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON-RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Valuation or S2,000
Signature of Auditor
Other land
(2)
Total land (line 1 plus line 2)
(3)
Residential improvements
Dwelling
(4)
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 pfis line 7)
(g)
1 hereby certify the above is true. correct. and
complete.
Signature of Assessor
Date signed
ig action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19_Pay 19_
Lesser of 1/2 Homestead
S
Valuation or S2,000
Signature of Auditor
Date signed