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STATE FORM:WM iR/WO MEASURER PORN CIA S.RON PRENRIBED BY ME DEPARTMENT OF LOCAL REPROVED BY STATE BOVROOF
IMPORTANTtNOTICE TO HOMESTEAD PROPERTY OWNERS
' Gibson County Auditor
101 N Main
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 incenmr than eser 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 receise the
hearth and to provide additional identifying inform ution necessary to allow county government to better monitor homestead
filing.This information will he kept confidential and can only be accessed by authorized county officials.The Department of
Local Government Finance will ow this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY LNFORMATION
Taxpayer Name Property Address
Deno, Melvin E/Anita G
PO Box 63
Oakland City IN 47660
1878
Melvin E Deno
597 S SR 57 State Parcel Number Legal Description
OAKLAND CITY IN 47660
26-14-18-101-000.319-006 003-00319-00 FARMER 8 SON TRACT 1
C-1
. - - - - - -_ X . -- - — - -
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
t1 elvin i e De/70
ig Address(number and street,city,state,and ZIP code) [ .Same as property address
77 ,VouH/i elf Rd 57
Spouse First Middle Last
4111-1Cei C Dell
Mailing Address(Number and street,city,state,and ZIP code) Same as property address
PART 3:CERTIFICATION ' 33
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 nature Date
q� CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDIT /STANDARD DEDUCTION HC10
State Forth 5473 (R5 / 10 -01)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
I (we) certify t on th 1s ✓dayaMarch 120
I (We) occupied as our pdnc al place of residence the following described real property for whi - "a Homeste acj3r6pertgH 'r8dis`hereb`"yil`aimed:
❑ l(We)owned ❑ Are buying under contract GIBSON COUNTY AUDI tart I
®- -lave 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.
CONTRACT'RECORDED ^,. -. ...5
If buying on contract, Fee Simple owners name
Recorders office where contract is recorded Record number Page
-PROPERTY .DESCRIP,TION
Coun
Township
Taxing district (city, town, tm ip)
Par A
Legal r Y n I pfoperty in question:
/rte
``��
/ ❑ Real property ❑ Mabile Homo (I.C. 61.1 -7)
If any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that structure is used to produce income, describe the use and portion
of the property utilized to produce income.
.319 -e"e6
. -- t' PROPERTY OWNED BY CLAIMANT IN OTHER'.COUNTIES 1
County
Tmnship County
Township
I hereby certify the above statements are true, correct and complete. o aimant
1 rgss number and str et, cit}; state, ZIP code)
�J 7660
'�'.? ` `•1/ 4 "' -'- < <-�'
'� `TRUE TAX
ASSESSED VALUE
.HOMESTEAD
.. a J NON - RESIDENTIAL -
ASSESSOR,USEE ON LYf
y-
i VALUE:
AT 1001/6 OF. TTV
� VALUE ts J;
��i' ' -VALUE %.-.
{y
_
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
s: k
Otherland
(2)
ii _
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
Residential improvements
Garage
6
"�.
Other improvements
(6)�-
•.�
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(6)
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 1f2 Homestead
Valuation or $6.000
(r