Homestead_Hicks (4)L
11
C
9 CLAIM FOR HOMESTEAD PROPERTY TAX
STANDARD /SUPPLEMENTAL DEDUCTION
e State Form 5473 (R:12115-09)
Prescribed by the Department of Local Government Finance
INSTRUC77ONS: See reverse side forliing instructions.
FORM
HCT70
rJ E
YEAR
N
CERTIFICATICN STATEMENT
I (we)
certify thatch( ) oceu led as my (our) principal
place of residence or am (are) buying the following de real property for which a Homestead Property
Tax SFanAm ue� is hereby claimed
under contract on the date this application is filed, (date of filing):
�� \j
❑ I (We) own ❑ Am (are) buying under recorded contract
GIBSON COUNTY AUDITOR
❑ Am (are) entitled to occupy as a tenant - stockholder of a cooperative housing corporation
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified personal residence trust
INFORMATION
CONTRACT RECORDED
If buying on contract, Fee Simple owner's name
Recorders office where contract is recorded
Reoord number
Page
PROPERTY DESCRIPTION
County
Township Taring district (city, town, ro
nsil
P number
303 -
I Legal descl lion
aac. -O QS
Is the Property In question:
❑ 1:1
Real property
Ann uaQy assessed motile home (IC 6-f. i -7)
I any portion of the residential stmchlra o the land not exceeding one (1) acre that immediately surrounds that structure is used to produce Income, deserbe the use and portion
of the property utilized to produce income.
PROPERTY . BY
County township County
Township
I hereby certify the above statements are true, correct an
rem (number and sheet, dry, state, and ZlPcode) ,
• Ft
yl2 v. J;510 D S
ASSESSOR ONLY
. r
Land not exceeding 1 (one) acre immediately '
surtoundin residential improvements.
Other
land (.
Total land (line 1 plus line 2) (;
Dwelling (
dal Improvements or Annually
.t`v�%5s' -g aa.yy'^,=--
Assess
Assessed Mobile I Manufactured Home
t
Garage
Other Improvements (E
Total Improvements (line 4 through line 6) (7
Total value (line 3 plus line 7)
I hereby certify the above is true, correct, Si
to signed (month, day, year)
and complete.
Venying action - Signature of Auditor
Dole signed (month, day, year)
STANDARD
20 pay 20 Lesser of 60% of the assessed value of the homestead or 545,000
Notwithstanding any otherpro%=on, the sum of the deductions provided in IC 6-1.1 -12 to a mobile home that is
S
not assessed as real property or to a rrenufacrured home that is not assessed as real pmpeny my net exceed
Vq H 2) M assessed value of the mob Be home or manufactunM hone.
r7JZAVbJ0oam
_
Date sm Ih Clay-ea�/
N
•
MATE FORM.!rm IC/••l TV.LNLIR FORM 7.5-1A
AFPRnvEn M ST ME I 30M31001AfrRA1Sbm PRESCRIBED DV TIE DEPA IMEW OF LOCAL GMrLMMEFa FI1:ANCE IC 6-11-224.1
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
mote beneficial,there is more incentive than ever for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
ILEA 1344-2009 requires taxpayers who receive the homestead standard deduction to eerily that they are eligible to receive the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filing.This information will he kept conlidauial and can only be accessed by authorized county officials.The Heparin=of
Local Government Finance\Sill uw this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
— Taxpayer Name Property Address
Hicks, David N/Angela D
Po Box 41
.- Francisco IN 47649
1732
David N/Angela D Hicks e2 10- 13-11 -003 °°°°7 57-a2.5
Po Box 41 State Parcel Number Legal Description
Francisco IN 47649-0041
I IIIIIIIt IIIIIIIIIIIIIIIIIIIIIIIIIItIIr IIIIFIIIIIIIrllllllllrl - 012-00141-0o OLD PLAN 60
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
l• NeCs1 A t c1<S
g Address(number and street,city,state,and ZIP code) Same as property address
o R)01\IA\ D,o6 St Vouy$%-, S-Ve Frknc, , .zN L-1-7fry9
Spouse First Middle Last
A \rp�e\o- Ja W-'l A I C-1iS
Mailing Address(Number and street,city,stale,_and ZIP pc—ode) �j �/ .171 Same as property address
-P O {b0'iv Lt 1 (it S, IF-0 Lk Fir V. S�1-c 1 F t vvc t?cb z N 4-1 to(19
- - -- ------- ---- __�
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.
Ow si t� Date
PART 4:ADDITIONAL INFORMATION