Homestead_Cansler a1ATE FORM J!M net 1RFWIIIR FORM 1IA
.APPMT'EO DV STATE B(SVmK MY,RFSTl 10v PAFYRIam nT Ulf OFPARf4LYt OF LOCAL C.IWERV•rh7 FINANCE IC 6I.I-21al
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 1343-2009 requires taxpayers who recehe the homestead standard deduction to verify that they are eligible to recehe the
benefit and to provide additional identifying informaton 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 Department of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART I:PROPERTY INFORMATION
Taxpayer Name Property Address
Cansler, Mark W
R 2 Box 278
Oakland City IN 47660 �s
5147
Mark W Cansler
802 W 1225E State Parcel Number Legal Description
OAKLAND CITY IN 47660
26-14-18-204-000.881-006 003-00881-00 PT SE NE 18-2-8.21 AC
C-1
PART 2:TAXPAYER INFORMATION -
Owner I First Middle Last
a(4 (/Ue c 1or� Ca4s/A,r
t — —"Same as property eddies:
001. S /al Q6E 2a1/041 C 711/ 5476°
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as property address
Social Security Number(last 5 digits) Drivels License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
sea
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 FORM
CREDIT/STANDARD DEDUCTION HC10
State Form 5473 (R614-03)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for Ming instri,clions
YEAR
CERTIFICATION STATEMENT
I (We) C_Ith�L ax _X�(_OD certify that on the 1st day of March. 20
1 (We) occupied as our principal place of resiLence the following described real property for which a Homestead Property Tax Credit is hereby claimed:
I (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.
If buying on contract. Fee Simple owners name
Recorders office where contract is recorded Record number Page
PERTY DESCRIPTT100,1
P R D 7
County
County
Tow ship
Taxing d I I (city, town, township)
I C ;I 11IL—Vsk �Q_ "
Parcel number
Legal description
Is the proper4Aquestion:
Signature ant
\ - (-�)C>
Wss (number and ZT star 7
I 4f
Cal Property ElMobile Home (I.C. 6-1.1-7)
If any portion of the residential structure or the land n of exceeding one (1) acre that immediately surrounds that suu&uro
is used to produce income, describe the use and portion
of the property utilized to produce income.
1,4
�- 0,FiopEkry.6WNEDBYCLAIMAkTIN.-OTHER'-COU14TIES��';I %
County
Township
HOMESTEAD
County
Township
I hereby certify the above statements are true, correct and complete.
AT 100% OF-TTV
Signature ant
Signature of Auditor
Wss (number and ZT star 7
, 4 _zf/ y"y64
0
19'-ASSESSOR USE Y
TRUE TAX
ASSESSECIVAILLIE
HOMESTEAD
NON-RESIDENTIAL
---VALUE
'_
e-�! 1.- �Z� �-
` VALUE
AT 100% OF-TTV
VALUE
Signature of Auditor
. .- . 2r' � . — , � -
I - . -
I .. I
- .1. _.
Land not exceeding I (one) acre immediately
surrounding residential improvements.
Other land
(2)
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
Residential improvements or Annually
Assessed Mobile/ Manufactured Home
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus 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
20 _ Pay 20
Lesser of 112 Homestead
5.
valuation or 535.000
Signature of Auditor
Date signed