Homestead_Hughes 3
STATE I ORM'YR*IR_/NNI TREASURER TORN 13-1A
APPROVED BY SATE BOARD OF ACCOUNTS.9n etrf[WBFD BY nu DEPARTMENT OF LOCAL GOVERNMENT FI:&NCE M I-I.1--_4.I
G3ibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead standard dauction.As the receipt of this deduction becomes
more beneficial.there is more incentive than ever for homestead fraud.homestead fraud causes higher In bills for all:therefore.
• HET 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to recehe the
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 Ikpanntent of
Local Government Finance will use this infomuatiun to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Hughes, Eddie/Melissa ` v3 N °cc' ci S S
a,1` P O I66
r, / Francisco IN 47649
1760 '//1/
Eddie Hughes 1 bI � `Qcns 5}. \�
f O BvI P33• State Parcel Number Legal Description
FRANCISCO IN 47649-0233
�r�n��ru�r��nr�n��t�nllIul t�u��rn��nr��ru��n��nl 26'13-20-101-000.131-005/12-00131-00 PT NW NW 242-9.36 AC
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
Ed , e , fps
•ng Address(number and street,city,state,and ZIP code) 1.Same as property
\ 03 N . Q_-coss s-N- I (mac) an 911M9
Spouse First Middle Last
-Q„\\ ssa— s ,
,� ,,\\ S
IMP
Mailing Address(Number and street,city,state,and ZIP code) l Eysame as propeny jd.ress
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 1 Signature Uat.. 1 r lb
•
CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR,
CREDIT/STANDARD DEDUCTION HC10,
State Form 5473(R6/4-03) It
Prescribed by the Department of Local Government Finance
INSTRUCTIONS Spa a.r•,, c;Ho f— fin— nnn L
I (We) certify that on the,1st day of March 120
T—�
I (We) occupied E ou pd7ncipalpla, .of res�ide�nicathe following described real property for which a Homestead Property Tax Wit
is hereby daimec
❑ 1 (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 owns the property or is buying under a contract.
M0-44W NTRACT.!RECORDED
If buying on contract. Fee Simple owner's name
Recorders office where contract is recorded Record number Page
gs�
County
T
Taring disftict_ ,town. township)
I
'
County Township
I hereby certify the above statements are true, correct and complete.
cr� S viJ
Parcel number
Legal description
Is the property in question:
(94� — a
❑ Real property ❑ Mobile Home (I.C. 61.7 -7)
e
If any portion of the r4
of the property utilized to produce Income.
a land not exceeding we (1) acre that immediately surrounds that suucture is used to prod" incanne, describe the use and portion
(::zV —/3 — o— eve).
gs�
County
Township
HOMiff9b
County Township
I hereby certify the above statements are true, correct and complete.
Signature of claimant I 11
ddress (numb
,A 0 -� a
and street, city; state, zip 0)
ohnss 4nojqci-�re-)
1
a�i, LP/z�q
ASSESSOR USE ONLY
' `TRUE TAX
ASSESSED VALUE
HOMiff9b
WO 'Q
T W "
= VALUE-
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
Other land
(2)
51 . 5-
Wm5ilvl ION,;
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
WU
Residential improvements or Annually
t- �
Assessed Mobile / Manufactured Horne
Garage
(5)
M2151
zz
Other improvements
(6)
NV 5 N
m�M$TX ,
ALM W
Total improvements (line 4 through line 6)
(7)
Total value (fine 3 plus line 7)
(8)
1 hereby certify the above is e, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Vditbr
Ak,
Date signed
"'W
20 _ Pay 20 _
Lesser of V2 Homestead
i-"uabm or S35.000
S
signed
— Z�- o