Homestead_Hamm etAE tOR4! e.de/..Yq LRE'SUIR LOLM—IA
APPWA'EO BY xi at.IXNRO M Art"r“•'r{.`lm PRLICAMFD BY Tilt BEPARieEeT OF LOCAL C VELYMR7 FINANCE r.-it-r4.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 IndividuaLs and married couplet.are limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than e'er for homestead fraud.Homestead fraud cause higher tax bills for all;therefore.
III HEA 1344-2009 requires taxpapen who receive the homestead standard deduction to verify that they are eligible to receive the
benefit and to provide additional idenrifvine information nectcsary to allow county government to better monitor homestead
filirgn.This information will he kepi cnnedentinl and can only he 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 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Hamm, Phil E/Mellanie M
R 2 Box 37
Oakland City IN 47660
5611 - _ _ . _ - _ _. .
Phil E Hamm
12093 E Hickory Lane State Parcel Number Legal Description
Oakland City IN 47660-8114
Itittllttt ltilttt llt tllrttitrltt rtlltr tlltlttlitit tt tlltt tt lli 26-14-19-203-001.018-006 003-01018-00 WATT ADD SEC A 10
C-1
•
PART 2:TAXPAYER INFORMATION
Outer I First Middle Last
fii i—le IP +) wt. ,I14-mm
�ag Address(number and street,city.state,and ZIP code) - - — __ _ _ —_ --er, a piapcm address— _.-_ _ . _
12093 E. / kKog l �l
Spouse First Middle Last
.lktU-4Nic mgicitit fMM
Mailing Address(Number and street city,state.and ZIP code) Same as property 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 prdpert Each-undersigned also unde rstandrthet,by-claimingadditional.homestead deductions ___
unlawfully,he or she ma - liable for back taxes and substantial financial penalties.
Own Ignature Datc
-
•
7
CLAIM FOR HOMESTEAD PROPERTY TAX
Ffct YEAR
CREDIT /STANDARD DEDUCTION fj
3 -.Me Form 5173 (R7 / 5-M
W
r;<zibeA by to oepartrrant or Local Grrerrrnent Finance � DEC 2 8 2006
INSTRUCTIONS: See reverse side for filing instrucb'ons.
CERTffICATION STATEMENT
I (We) -T' _ _ certify tW dtr6m f Anti l oi-
I (We) occupied as orr principal pla n: ; esidencr_ the fchU ing described rr�i pope:?- for which a Hom stead Preperty Tac Credit is hereby claimed:
l (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 awns the property err is buying under a contract.
CCN77ZACT RECCR ED: - -
r buying on contract. Fee Single ownees mm —
Recorder's olfice where contract is retarded Record number Page
_- ... y...... ... - ..
- .. .: I , PROPERTY DESCRIPTION,: :..
._'-. •:.';. - _ •'. _, .: - a ; .....
cetmty
Tomnitip
Iad town. f
-)
m bl
=1
Q
Parcel number
L descnptX I Is the pmperty in question:
,
O/ O
/j
/I I ef
Real property Mobile Home (f C. G1.1 -7)
If any portion of the nsiderdial structure or the IoW nor exceeding one (1) acre that inrrndalely aimaalft that Iflucture
is uaed to produce ewoma, describe the use and portion
tithe property ubfrzed to orod<rte income.
'VALUE. ?
!/
� P *d6- 1419- a63- COioi'-
s
cl_AolulTEi OTHER COUNT1ES�r .
County
Township
County
Township
I hereby certify the above statements are true, cared and complete.
m bl
'cress (nurr6d aW street, ay. state ZIP code)
Z Sox 3-7 kL4,v Lti , a,� y -7
F1
• ASSESSOR USE '•
- (,
TRUE TAIL
t
ASSESSED VALUE
Ii01�STEAD
`..
NONRESIDEhI71AL
ONLY •
VALUE'—
AT 700%OF:TTV
;
-. VALUE
'VALUE. ?
_
Land not exceeding 1 (one) acre inmtediately
surrounding residential improvements.
_
r
Other land
(2)
Tdal land (fine f plus line 2)
(3)
Residential improvements or Annually
(4)
Assessed Mobile l Manufactured Hone
Garx+e
(5}
V
n
Other improvements
--
Taal improvements (fare s Mryerh one Al -
- - --
I rTt --- ... -
-- - - --
- --- --
- -
--�— - --
— — -
-- - --- -- - - -
- - - - - -- -- - - -.
Tdal value ((ate 3 plus fine 7)
1 (8)
i
- _—t
hereby certify the above is true, eared, aW
SQnatire ofr,sessQ
(Dares .,d
--
complete - ----
-- ---- 1. -- - - --
--
—
-- - -- -_.
Varlyog action - Sgrmbre of AudNw
i firm 71-1
20 Pav 20 —
Lesser of 12 Homeverd
Valuation a 535.000
A
15
Sgnaore of Aa6mr I We signed