Homestead_Ball '
STATE FORM!Mt.tit:I....PI TREASURER FORM 7S-IA
.VPR[R'EO fly R UL BOARD OFAMPUNTS.vx PRIS'RIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE M 6-1b"-RI
Gibson County Auditdr
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 eta for homestead fraud.Homestead fraud causes higher tax bills for all;therefore.
111-
I HEA 13-14-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to recene the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
tiling> This information will be kept confidential and can only be acceieed by authorized county officials.The Department of
local Government Finance will use this information to create tools that will help county officials eliminate homestead(mud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
_ Ball, David
RI Box 5
Oakland City IN 47660
1865
David Ball
364 S 1150E State Parcel Number Legal Description
OAKLAND CITY IN 47660-8603
26-14-07-300-000.020-006 003-00020-00 PT SW SW 7-2-84 AC
Illlllllllltlltiolllllflllllllllllllll litill nInIIItnI „ / C-1
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
Au ( 1) ALAti MU-
tg Address(number and street.city,state,and ZIP code) l�Same as property address
Spouse First Middle Last
L A v U ELI ZAPETH ?ALL
Mailing Address(Number and street,city,state.and ZIP code) Same as properly address
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 Si r Date
•
CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDIT /STANDARD DEDUCTION
State Form 5473 (R614-03)
Prescribed by the DePantment of Local Government Finance
INSTRUCTIONS: See reveres &War for fift kdftcffont
STATEMENT;%.-�,_',.4
CkIRTIFICATION
(W certify thaAfie'1sld;ayo-f 'March, 20
(W:)
) occupied as our principal place of residence the following described real property for which a Homestead Property Tax Cr tjs hereby claimed:
❑ 1 (We) owned ❑ Are buying under contract
IV
Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns thejSBBVAdBQ1AbqrYg 'Lrndbr'icontract.
41-14 �IMIQIIW NTRAcT.-' R ECORDED
If buying on contract. Fee Simple m,mees name
Recorders office where contract is recorded Record number Page
k-dP,-E0T'46WNEEFBY CI!AIMAN-T 14-6THER.
PROPERW,
County
Tavnship
TaKing district (city, town, township)
Parcel number
10(17 , rte/ r^1
I
4� so' g> 11
s the property in question:
❑ Real property ❑ Mobile Home (I.C. 61.1 -7)
If any portion of the residential structure cr the
of the property utilized to produce income.
land not exceeding one (1) acre that immediately surrounds that structure is used to produce Income, describe the use and portion
Land not exceeding I (one) acre immediately
ly, PKI
'& /— � :566
-40, 06 6
k-dP,-E0T'46WNEEFBY CI!AIMAN-T 14-6THER.
County Tmnship
Count Township
I hereby certify tify the ab ov e statements are true, correct and complete.
9n r of Ga'uh
I.-
VLn MA c1q
it A
- f
rat
'Mr-UMOV, WM.-
-iE
NMI-
OHOMEST D��
10N
ft-",jNONLRESIDEl-rq
Value" or 535.000
VAL
Land not exceeding I (one) acre immediately
surrounding residential improvements.
(1)
:ft
Other land
(2)
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
0
�Residential Improvements or Annually
Assessed Mobile I Mar"Fac"Od Home
Garage
(5)
k WHIMEK-rgm 0-9
Other improvements
(6)
It- R11
Total improvements (fine 4 through line 6)
(7)
Total value (line 3 pits line 7)
(.8)
I hereby certify the above is true. correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
DIN
Q�T,P29 STANDARD-MEDUCTIONALL ANCE
20 _ Pay 20_
Lesser of 112 Homestead
Value" or 535.000
Signature of Auditor
Date signed