Homestead_Gibbs I al arr.FOR M•)!m 4R2/1-11.) TREASURER FORM.:S-IA
ArFRm'EB BY Aarb WARD Of ACtTA T,.]n. ?Rr9[Rrnm By till DEPARran'.YT(f LOCAL QAERVMrwr FINANCE IC I.I-]`il
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
. PRINCETON IN 47670 Individual and married couples are limited to one homeacad crandani deduction.As the receipt of this deduction becomes
more beneficial,there k more incentive than eser for homestead fraud.Homestead fraud causes higher tag bills for all:therefore.
it HEA 1344-3009 requires taapayem 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
filing..This information will he Lept confidential and can only he accessed by authorized county officials The Depannent of
Local Government Finance will use this information to create tsvls that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
_ Gibbs. Carla/Lisa Hembree
R 2 Box 44
ajand City IN 47660
5629/
Carla Gibbs& Lisa Hembree
2182 S 1200E State Parcel Number Legal Description
OA LAND CITY IN 47660-8123 / 26-14-19-400-001.413-006 003-01413-00 PT NW SE 19 2 8 1.286 AC
IIIlllllllIlllinliIII'IIIIIIIIIIIIIIIIIIIIIielni IIIIIIIIIII C-1
X/
PART 2:TAXPAYER INFORMATION
Owner 1 (I 'r' First Middle Last
G:A.r a, qa.e_ — , 610
ng Ada, - number ands.• t.city,state,and ZIP code)--- -- — - Same as propcity address '' - —-- -- --
I )‘ 1 \a&oe )C\&,-, (;a- i'l kii(olgo
Spouse First Middle Last
a i Address(Number eet city,stale,and ZIP code) ❑ Same as property address
Social Security Number(Last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please spaify in Pan 4 below)
sow
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 Signatur Date
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (R6I4-03)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
I (We) (Akkol Q. L; tyA 1 S ( , L Au
I (Vt{e) occupied as our principal place of residence the following described
I (We) owned El Are buying under contract
FORM YEAR
HC10
certify that on the Fts t da; 0 I AA'11 2pp0"N�
for which a Homestead Property Tat Credilrjs h eby cX;d:
1111 A--/ L–j .
Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is buyi4(ur'6erja "R3
If buying on contract. Fee Simple owners name
contract is recorded
Record number IPage
h
9 ,'-,. e3-" }, fi,•, 'S P. ROP. ERTYaOWNED_ BY; CLA) MANT_ INOTRER "COUNTIES`aV!,E –;,
RPI:UESCR)PTION?
County
Township
T - is (city, toryn. township)
dress (number andd street, city, state. ZIP code)
I i /�r cv
Parcel number
Legal description Is the property in uestlon,
Wz - D 3 — C50
Real property ❑ Mobile Home (I.C. 6-1.1 -7)
H 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.
wVALUE
- /5'-/ 9-
a- a/. *� -aa�
h
9 ,'-,. e3-" }, fi,•, 'S P. ROP. ERTYaOWNED_ BY; CLA) MANT_ INOTRER "COUNTIES`aV!,E –;,
County Township
County Township
hereby certify the above statements are true, correct and complete.
Sig ure of claimant
dress (number andd street, city, state. ZIP code)
�.!2—
AEq-
i'...-
RUETAXr
' 1`'
ASSESSED VALUE
'
4HOMESTE fi =•
NOOWRESICENTIAL rah
Sif.:� .FS.� . �l- �RSE,NLY:. r
wVALUE
eAT3100%: OFTIV�
,','fVALUES.,,_'VALUEy+`a.
7.e',
Land not exceeding 1 (one) acre immediately
` 'f =cam" sx.-` '
er•3."5
surrounding residential improvements.
(t)
�;�r�A*,.i*��•�",.>x"'�?a•.
y am} �,`;
Other land
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
-..
Residential Improvements or Annually'u.�a�...�.
Assessed Mobile I Manufactured Home
Garage
5
ri"4 ik°7 uvY"`w +' T
Other improvements
(6)
"'r s
-
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(g)
1 hereby certify the above is We, coned, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
°F. 7 %; ,= e ,•&,r– y �.``a- --tiY '" ' MSTANUARRDEDUCTION',ALLOWANCE; -.�5l"�7^ a�°;`�t',' -tt >, sor'`"t>""4�"1..-'URVO NYC' asYc
20_Pay 20_
Lesser of 1P2 Homestead
$
Vauatton a 635.000
Signature of Auditor Date signed