Homestead_McDaniel (9) • 5l{IE FORM 535e. r.tiM) TRF SOEEI PoRNTSM
APPROVED BY STATE WARD OF A XtLr54n PtEYTIBW BY THE OEPARMEIT OF LOCAL roYTrolna MQ:S.M.E le si.1rat
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
more beneficial.there is more incentive than ever for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
• HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to mcene the
^e�-�,' ( benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
I 57--(
filings.This information will be kept confidential and can only be accessed by authorized county officials.The Depannlem of
E Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
APR 7 ZULU Taxpayer Name Property Address
McDaniel, Regina
Ara Af�,+(!(/ 718 E State
GIBBON COUNTY A( tilIVR Princeton IN 47670
930 •
Regina McDaniel
718 E State State Parcel Number Legal Description
Princeton IN 47670-1912
NS
Itltrlitrrlrllrrlrttlil 111.1 11rt1r1r tr 111rr1rr1rr 11 26-12-07-204-002A28-028 08D S4B8-0(1 T
BS OT 1 PT R3
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 1 First Middle Last
1�6)9 Any � �� A10 e /
g Address(number and street city,state,and ZIP code) ❑ Same as property address
Spouse First Middle \ Last
rrte 1 {%„ l_
Mailing Address(Number and street,city,state,and ZIP code) 1 Same as properly address
r r
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Pan 4 below)
_ _. sue
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
•
��'`"""° CLAIM FOR HOMESTEAD PROPERTY TAX
� CREDIT/STANDARD DEDUCTION
� State Fortn 5473 (R2 / 592)
_,i
INSTRUCTIONS: See reverse side lor �ling inshuc6ons.
FORM
HC10
YEAR
'� RTIFICATION ATEMENT . .,. „ i � ��—._
I(We) � ��, c�rti that� n tiie- st day of March, 79_
I(We) occup d as o r p ncipal place of reside ce the following described real property for which a Homestead Prnoperty 7a�c Credii is hereby claimed:
❑ I(VJe) owned ❑ Are buying under contract 1���D / f' , L'�• -�
❑ Have a beneficial interest in the eniiry that is liable for the propeAy taxes on the property and tha� wns the�erty is buyi un r a contract.
,i
CONTRACT RECORDED �""�'" ���TY :.UUITd�
rs^�
Ii buying on conVact, Fee Simple owners name � "—
Recorders office where mnvact is recorded _ Recortl number Page
PROPERTY DESCRIPTION
Counry Township Ta�ing tlistrict (ciry, town, township)
Ipu er Legaldesc^nptio � _ �
� V
portion ot the resi ential structure or Ihe land rroi exceeding one (t ) acre that immetlia[ey surtounds ihat sWCiure used to produce income, describe the use and poNOn ot
Ne property utilizetl ro pm0uce incame.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
Counry Township - � Township
/
Si nat f
�ereby certify the above statements are true, correct and complete.
Address (number antl s et, d, stafe, ZIP catle) �
' �
ASSESSOR USE ONLY TRUE TAX ASSES HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not exceeding 7(one) acre immediately (� �
sunounding residential improvements.
Other land (2)
Total land Qine 7 plus line 2) (3)
Dwelling (4)
Residential improvements ,
Garage � (5)
Other improvements � (6) '
Total improvements (line 4 through line 6) (7)
Total value (line 3 plus line 7) (8)
I hereby Certity Ihe above is irue, correct, and Signamre of Assesor Date signed
comptete.
Verirying aclion - SignaWre ot Auditor Date signed
•1 STANDARD DEDUCTION AILOWANCE
19_ Pay 19 _
Lesser of 1/2 Homestead S
Vatuation or 52,000
Sigrature of Audiror � Date si netl
a�-�