Homestead_Weber (3) • S ME FORM!)R's tie 1 WI IAE4SUtn FOLM:}IA
.APPROVED BY STATE M•ID Of M?T*.NTS_-nw PRE9(RIBm BY tilt DE?ARMEYT OF LOCAL GOVSIINNINT FIANCE M 6-I.1-22.4.1
Gibson County Auditor
101 N%Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead ganders!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 1344-2009 requires taxpa■ers who receive the homestead standard deduction to serifs(tlut they are eligible to recehe the
benefit and to provide additional identifying infornuuon necessary to allow couny government to better monitor homestead
filings_'Ibis information will he kept confidential and can only be accessed by authorized county officials.The Depannrem of
Local Goverment Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Weber, David J 7o (, 3 r I sOS
Princeton IN 47670 rr.V _
2450 /6L1
David J Weber
7063E 150 S State Parcel Number Legal Description
FRANCISCO IN 47649-9036
I I I I III I I I I I I I I I I I I III 26-13-20-200-000.370-004 002-00370-00 PT NE 20-2-9 25.195 AC
r u nr t nt n r n t n n nt nn nl r ` - C-1 D-7
PART 2:TAXPAYER INFORMATION
Owner I / First Middle Last
�Javl aides Wede r
•g Address(number and street.city,state,araci ZIP code) El as property address - - —
70 & 3 F' / SOS j ran c , sco J4) V 76 `f 1
PART 3:CERTIFICATION
Each undersigned certifies,under penalty of perjury,that the above and foregoing information is rove and correct and that he or she is elieible 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 Ca., Date
CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDIT /STANDARD DEDUCTION HC10
State Form 5473 (R6 14-03)
Prescribed by the Department of Local Government Finance -
Y
INSTRUCTIONS: See reverse side for filing instructions. ^( I
�s?' "`...e="`te -e ;.,a':t9:CERTIFI
[ ///
Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the pr'opertyo s buying•uhder-a contract.
a. x ..�w+�a
z CONTRACT'RECORDEDr`�3t
If buying on contract, Fee Simple owners time
Recorders office where commicl is recorded Record number Page
s- *'u.'`w�•*�s..it fix.
:
County
Township
Taring district (city, town, to ip)
r
al d
O
Is the property in question:
GW
_
Rail property ❑ Mobile Home ( /.C. 6-1.1-7)
If any portion or the residential shucWrA or Ne W id not exceeding ono (1) acre that immediatefy surrounds that s cture is used to produce income, describe the use and Portbn
of the property utilized to produce income.
C-.4;'6 �� -moo- Boa -Coo .3�
rA I I
F °- L't'`'` -"—
•+. '+ YASSESSOR�USE ONLY •z
�UETAX
VALUE {'� `:-`
County Township
County Township
1 hereby certify the above statements are true, correct and complete.
Si t ure of cla t
Address (number and street, city, state, ZIP code)
F °- L't'`'` -"—
•+. '+ YASSESSOR�USE ONLY •z
�UETAX
VALUE {'� `:-`
ASSESSEDVALUE
T�100 %'OFTiV
�.,...i... -mot
�eHOMESTEAD'`
VALUE
3t... ... -.aa
NON=R ISE OENiIAL'
y VALUE ` '
zar. -i a i'iz`w�'Are
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)h4
• =e"Y.' ,��E�yr:
Other land
(2)
Total land (line 1 plus line 2)
(3)
Dwelling
(4)_cx�.m
� v+r:
JAB
,.7r..
Residential improvements or Annually
3
Assessed Mobile I Manufactured Home
Garage
(6)
WRIT,
'y _
Other improvements
(6)
fit. �+1 tj
OWN
Total improvements (line 4 through line 6)
(7)
Trial value (line 3 pits line 7)
(6)
hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
20 _ Pay 20 _
Lesser of 1A2 Homestead
Valuation qr S3S.000
5
Date signed
7)---7- r- r 1r-N ,- --e..