Homestead_Hoover (3) STATE FORM"PANG t r HNI TREASURER FORM T-IA
APPROVED
TO HOMESTEAD PROPERTY GOVERNMENT
OWNERS '4
Gibson County Auditor
101 N Main
PRINCETON IN 47670 bWividuaLs and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than net for homestead fraud Homestead fraud causes higher tax bills for all;therefore.
it HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are clieible to remise the
benefit and to provide additional identifying information necessary to allow county.government to better monitor homestead
filin6.This information will be kept confidential and can only be accessed by authorized county officials The Ikpanment 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 Property Address 1 (�
Hoover, Patrick S/Jennifer L /5.09 fliNv.)fihovna "
— —.He'Sinter
Hauhstadt IN 47639 Q V
707 //'�� �L
Patrick S Hoover n9-
1509 Hawthorne Ct State Parcel Number uv Legal Description
PRINCETON IN 47670-3334 /
26-12-06-401-003.973-027 006-03973-00 NORTHBROOK HILLS
t I II m II II ll I ul III 1111.1111111111.111111•11111811111 / / PHASE IV 78
— __._ — _ —
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.
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
Pc—HcK Shawn fJoo■ u'
Ong Address(number and street,ci state,and ZIP code) Same as property address
1509 -Ha Wf orne Courf Princeton ; iN 117670
Spouse First Middle Last
JenniPer f_e-iigh Hoover
Mailing Address(Number and street,city,state,and ZIP code) Sterne as property address
1509 fkO horn ('oor'1 P!'ince`n i IN 47670
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 may be Iiabl- or back taxes and substantial financial penalties. /
0
•
r, CLAIM FOR HOMESTEAD PROPERTY TAX
� CREDIT/STANDARD DEDUCTION
t ♦ State Fwm 5473 (R6I403;
Prescnbed Dy Ne Departmem ol Local Govemment Financ:
/.4NSTRUCTIONS: See �evasc sidc loi /ilin�� insliur.fion}.
��
FORM
HC10
YEAR
=:.3° ^ r� .i'.. �-... '^r�.--.+. .'�i�'. . .t IIhIGAIIUNSIATEMENT.--. � .
I(We) certiry thatVn'(he ts���arch. 20
I(We) octupied as our prindpal pla f residence e following described real property for which a Homestead Property T�c Credit is hereby daimed:
❑ I(We) owned ❑ Are buying under contract ,Q/y�/(+/�'
' Have a benefidal inlerest in the entity that is liable (or the property taxes on the property and Nat owns tt��grg�� �ry�rnad��contract.
If buy'u�g om m�tract. Fee Simple ownefs name
Recordef5 olfice whera conUacl is recorCed
Tavnship
RECORDED."�'-......- -� - :`,i:tif�:*.'� -. �
Record number Page
°_SCRIP.T�ON'�,. �' . .. . - _- - - -?:t;';_�;;
T�cing dislrict (cify o�yn shi ) lJ ./\
�/ �/ r" w I/ J �I `�f esc'p��^ y,�/% � w_ /)/ /� lhe Prope i question: '
l0� r� � i � � a ��rin � r_
I/ 7••/ •••�•o"c�t� � G Perty ❑ M11ob'lo Ho o U C 6f f-7)
If any poNOn ol the ravdenUal sWClum w the Wnd not xceeding one (1) acre t�at immediatey surrounds that swaure is usea to praduce inwme. tleuribe the use and portion
of the propeny utilized to produce iriwme.
a�-ia -o �-�v � - �o �. 9 �� -oa�'
Counly
Tavnship
I hereby certi(y the above statements are lrue, cortect and complete.
A�SS (number and sbeef ui , fare, ZIP o )
��� q ����i0'�'Gv � �
of
�U
��aT y��� r ASSESSOR�-0SE ONLY __ TRUETAX ASSESSED VALUE .'HOMESTEAD NON-RES�DENTIAL�
��,�iri e, �.B ::.rF _.�...,-a.,-r�.; . - . `� VALUE AT 100% OF.TTV - VALUE �;>�.- VALUE: � .
Land not exceeding 1(one) aae immediatety —'�i�;`->=,r-":'`'� `�}'.
surrounding residential improvements (�� . .. � � � �
O�herland (2)
T�tal land (line 1 plus line 2) (3�
Dwelling (4) -',..�..:'S.::i;.,�i�.'��.:'_;.:.;:'.'�:
Residentiel improvements or Mnually
' :_ .e.�,.-t,;,,
PssessedMobila/ManufaduredHOme Garage (5) I ��.-�''•; .._ .
Other improvemenis (6)
TUaI improvemenLS Qine 4 through line 6) (��
TKaI value (line 3 phs line n (g�
I hereby ceAify Ihe above is Irue, conecl, and Slgnamre of Asseswr Date signed
complele.
Venfying action - Signalure of fwtlitor Dale signed
��iYr':'�1�. �
20 _ Pay 20 _
Lesserof 1/2 Homesead
vawauon or 535.000
3
�'t'i/�O-0�