Homestead_Bailey (3) •
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.Arm'ED BY AxIL Bnv¢D OF YnENT1`9. PRES(RIBCW BY TIC OEPAR1x2Yr[f LOCAL r crrNMO.7 mascu' II-r-&I
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couple,are limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial,there is more incenrne than ever for homestead fraud.homestead fraud causes higher tax bills for all:therefore.
HEA 1 344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to recene the
® benefit and to provide additional identifrine information nccesory to allow county government to better monitor homestead
lilinse.'Ibis information will he kept conlidential and ran only be accessed by authorized county officials The Department of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taspaver Name Property Address
Bailey, Steven J
RI Box 249 ""
_ __ -
- Oakland City IN 476601 Y_ _.
4410 __ _ -_ .__ .—._.____-. _ _
Steven J Bailey
9363E 50 S State Parcel Number Leual Description
Oakland City IN 47660-8454
26-13=15=200-001.376-006 003-01376-00 PT NE NE 15 2 9 3.76 AC
I tI I I i Ii II tit I I I I iI I I I tI LI ttI ttI t I I ti IItI t I I
C-1-D-6
_ PART 2:TAXPAYER INFORMATION
Owner 1 First Middle Last
/ '/
ilikSkW6
Address(number and street.city,state,and ZIP code) Semc as propertv a dtess
Lia6 60 Ckl C1 � Ind 47(o&o
Spouse First Middle Last
Social Security Number(last 5 digits) Drivers License/State ID Number (last 5 digits Other(please specify in Part 4 below)
2203'6 LAD
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 Signature Date '
•
1\
Nn CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Form 5473 (R4 I 8-00)
INSTRUCTIONS: See reverse side for fifirll; instructions.
FORM 1` YEAR
HC10
I (We) V v v A- -X certify that on the 1st day of March 20
I (We) —'a'-pki as I ce the following descri real property for which a Homestead Property TalrC-ei Ms her aimed:
(We) owned ❑ Are buying under contract V
lave a beneficial interest in the entity that is liable for the property taxes on the property and that owns the prop
e/6 or is buying and erfacolitract-
ONT
If buying on contract Fee Simple owners name
.Recorders office where contract is recorded Record number Page I
1UYICNA-1
N-� - P:110:: i2! I ii Z'qg' _ _�
County
Township Taring dis 117ty, town, j2rPjh'aL-
I t�
I hereby certify the above statements are true, correct and complete..
F �1-
L al description IF
If any portion of the residential structure or the land net exceeding we (1) am that immediately surrounds that structure is used to produce income, describe the use and portion
of the property utilized to produce income.
1UYICNA-1
h—kA Wf- I WdiKE
Coun!,,,.. Township
County ITownship
I hereby certify the above statements are true, correct and complete..
F �1-
� I
P, ]!? a qf claimant
4L
"•eu (number and street, city, state, ZIP code) -
CA /
qj QQkW A �A C/
11
STWD
�ARD DIEDI.Il:� I AC11C A C
20 _ Pay 20
Lesser of 112 Homestead $
Valuation or $6,000
Signature ofAuditor Date 7 ned
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T6S9 SSEDIVAWE'
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Land not exceeding I (one) acre immediately
surrounding residential improvements.
41=j 'NOW
Other land
(2)
g'9
Total land (fine I plus line 2)
(3)
Residential improvements
Dwelling
(4)
M-1
Garage
s M,
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (fine 3 plus line 7)
(8)
1 hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
Verifying action - Signature of Auditor
Date signed
STWD
�ARD DIEDI.Il:� I AC11C A C
20 _ Pay 20
Lesser of 112 Homestead $
Valuation or $6,000
Signature ofAuditor Date 7 ned
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