Homestead_Corn (3) .• STATE FORM 53549(R3 I B-10) " MEASURER FORM TS-IA
APPROVED BY STATE REAM OFACNUNTS 2109 VRESCRIBFD BY THE DFIARTMFIT OF LOCAL COW:0.W FINANCE IC 61.1-II-.1
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N. Main Street Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
Princeton, IN 47670. more bcn.frvial,there is more incentive than ever for homestead fraud_Homestead fraud causes higher tax bills for all;therefore,
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
•1
rr county benefit and to provide additional identifying information necessary to allow coty govenmrent to better monitor homestead
filings.This information will be kept confidential and can only be accessed by authorized county officials.The Deparunent of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
— � ��T T'\ PAR"1' 1: PROPERTY INFORMATION
{L� �J) Taxpayer Name Location Address
Corn, Matthew M/Emilee K
tIM 1 Q Z0%% 1790 S WHISPERING HILLS RD
C m tV OAKLAND CITY IN 47660
aj
1544 -.
NTY AUDITOR I Illllllf_0111IIII JIIII0111[IIII01111111111111:111iiini:1II CIII1111in:1[111 II
Mgi�6AMP@Sm
1790 S Whispering Hills Rd
OAKLAND CITY IN 47660-8672
lit'li'II"III 'Iu iIliIiIiill99__'lii'It1llluilliluuIttllltFlllii State Parcel Number Legal Description
26-13-23-101-000.957-006 /'WHISPERING HILLS 22
5
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.
: - -
Spouse First ',lJ I , Middle Last
Lmllee -en �Orn . .
Mailing attireslnumbe rand svecL`cirysTau-,ana i r cafe) — _ _.- — — _1 ,F.same as property address - - ' -c - _
l� l
• -
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
CREDIT/STANDARD DEDUCTION
State Form 5473 (R5110 -01)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
FORM YEAR
PROPERTY DESCRIPTION
County
Township
Taxing district (city, town. township)
Township
Le
al de c)zaz�-..
street, city, state, ZIP code)
jccl qu(ao
is the property in qu!s� . Jdn
n6l— 00151-W
2
'TTV
A L&I Q.Vral property ❑ Mobile Home VC, 61.1-7)
If any portion of the residential structure or the land not exceeding Ine (1) acre the medil!quffounds that structure is used to produce income. describe the use and portion
of the property utilized to produce i . ncome- CK 0%
-a?.5 4Z6
0 ko 0 E kTy 6W N E 6 BY CLAIMANT I N 0 T H E R ' C 0 U N TI ES
County
Township
County
Township
I hereby certify the above statements are true, correct and complete.
Signature of claimant
street, city, state, ZIP code)
jccl qu(ao
gg
E TAX
ASSESSEDNALUE
HOMESTEAD
�)NOWRESIDENTIALk�"--
'�A�SSE�SMIJISEONLV
t-s�.TRLI
VALLJE,�'
ATIO %
0 -O_F.,.
LqE V�
--��VALUE;'
'TTV
Land not exceeding I (one) acre immediately
surrounding residential improvements-
Other land
(2)
Total land (line I plus line 2)
(3)
Dwelling
(4)
Residential improvements
Garage
(5)
011�
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 john line 7)
(8)
1 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 1f2 Homestead
Valuation or $6,000
Signature of Auditor