Homestead_Moody (4) n. STATE.FOAM!3AIR:/Swl TREnSUamA FORM Sea
APPRrnED BY STATE B(MRD Of AYnttS.mry PLESQEBmnY HIE DTPARTME4T OF LOCAL rD%TtNMrM FPASCE M 6-1.Ir4.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and hurried couples are limited to one homestead standani deduction.As the receipt of this deduction becomes
_ more beneficial,there is more incentive than e'er for homestead fraud.Homestead fraud causes higher tat bills for all:therefore.
HEA 1343-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
benefit and to provide additional identifying infonnauon necessary to allow county government to better monitor homestead
tilintss.This information will he kept confdemial and can only he accessed by authorized county officials.The Department of
Local Government Finance will toe this information to create ads that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Moody, Neil A/Mary Gretchen
802 S Gibson
Princeton IN 47670
1510
Neil A Moody
802 S Gibson State Parcel Number Legal Description
PRINCETON IN 47670-2610
Illttlltttllllttltttlll IIII null!l ltttll tttttlllllBltl 26-12-18-201-003.469-028 019-03469-00 PT NE I&2-10.10 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
Nt I Aouwn rnbooy
g Address(number and street,city,state,and ZIP code) ® Same as property address
Spouse First Middle Last
M Ctir (�re-fzheVI n l god y
Mailing Address(Number and street,city,state,and ZIP code) El Same as property address
.-- - ----- — - —-
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
4� :.,,E o
a �
.,,:.
� ��
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CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Form 5473 (R2l 5-52)
FORM
HC10
YEAR
i
INSTRUCTIONS: See reverse side lor /iling instructions. . _
`i ,
CERTIFICATIO ENT
� e) Certi(y that orei0�7 s� o��gh. 19_
1(We) occupied s our principal place of residence t e o owing described real property for w' a omestead Property Ta�c Cre � is h b��
❑ I(We) owned ❑ Are buying under coniract �� /�-� ����_ � i r J
❑ Have a beneficial interest in the entity ihat is liable for the property taxes on the pmperty and ihai owns ihe pr"6peQ�3gp�uy(ng, �q� t.
CONTRACTRECORDED �
It buying on contract, Fee Simple owners name
Recordefs otfrce where convact is recorded Record number Page �
- PROPERTY DESCRIPTIO
Cou Township Ta�ting -s � i , ro , rownship) ,
Paccel nuwbe�� / � Legal descnptio —� — �
U l( / lJ
If any portion of Ihe residenfial structure or the lantl not exceeding one (1) acre that immediatety sunountls that structure is used to produce income, descri e Ihe use and portion ot
the property utilized to Produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
Counry Township . Counry TownShip
Si Nre o claimant
ereby certify the above statements are true, correct and complete.
Address (numberands7reet, ciry, sfate, ZlPcode)
oZ S ,�so.� rce�.-� 2n/ 7G7 0
ASSESSOR USE ONLY TRUE TAJC ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
tand not exceeding 7(one) acre immediately (»
surtounding resideniial improvements.
Oiherland (2) I
Total land (line 7 plus line 2) (3)
� Dwelling (4)
Residential improvements
Garage (5)
Other improvemenis (6)
Total improvements (line 4 through line 6) � (7)
Total value (line 3 plus line 7J (8)
I hereby CeAity the above is true, conect, and Signamre of Assewr Date signed
complete.
Veritying action - Signawre of Autlitor Date signed
STANDARD DEDUCTION ALLOWANCE
19_ Pay 19 _ .
Lesser of 1/2 Homestead S
Valuation or 52,000
Sig re ot Audi Date yipned�o �
C1