Homestead_Lee (5) 41nrE FORM!Mt.1R:r set TY.FACE'IER FOAM T51A
APPROVED BY 5151E 1.11.a°OF ArrOU T[.20N PAIYA1Bm BY fir DEPMTMEYT OF LOCAL COVERWI I r,c&seEICLI.E_a.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couple.are limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than ever for homenead fraud_Homestead fraud causes higher tat bills for all:therefore.
• HEA 1344-2009 requires taspayers who receive the homestead standard deduction to verify that they are eligible to recent the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will he kept conidmuial and can only he accessed by authorized county officials.The Department of
Local Government Finance will use this information to create tams that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION
Taxpayer Name . Property Address
Lee, Michael/Kathy
R2 Box 28
Oakland City IN 47660
2127
Michael Lee
1742 S 1200E State Parcel Number Legal Description
OAKLAND CITY IN 47660-8112
26-14-19-203-000.883-006 003-00883-00 PT NE 19-2-8.49 AC
Isl,ullioltlle tilli tllett lr rltrrrllr.dlttl16lteltlle11111rl C-1
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
ig Address(number and street.city,state,and ZIP code) 51.Same us property address
MI 9_ S Cloo k U GAL fJs-Np c \\`\ -- ‘.,, y -1 L i, 0
Spouse First Middle Last
Mailing Address(Number and street,city,stale,and ZIP code) 5 Same as property address
I -I-1-1 2 S I2oJ E ocA 1, ( c\c c_\-- a 1, -1 t is
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 1 i at uq' /\ Date
7
CLAIM FOR HOMESTEAD PROPERTY TAX FORM
CREDIT/STANDARD DEDUCTION HC10
State Fomn 5473 (R6 / 4-03)
Prescrbed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for fifitirr instructions.
YEAR
I (We) I 1 114 [1 CU N cL J�M k), 's- _AW _.� certify that on the 1st day of March, 20_
1 (We) occupied as our principal place of residence the toll, escribed real property for which a Homestead Property Tax Credit is hereby claimed:
❑ 1 (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-
A 1% 0 UTRA ;RECORDED_�
— 100WPA-,�;r_EX CT.
If buying on contract. Fee Simple owners name
Recorders office where contract is recorded Record number Page
_w mm
County
Township
Taxing disidet
(city, to". township)
C T
Parcel number
W3-
Le descd lion Is the property in question:
Address (number and street, city state, ZIP code)
a Real property ❑ Mobile Home (LC. 6.1.1-7)
If any portion of the residential structure or the land not exceeding one (1) acre that immediately sinroungs that structure is used to produce income, describe the use and portion
of the property utilized to produce income.
/X- /9- 0 3 -,W, YS3 -&V
F-IaM_t�' Pk6P.ERTYbWNEb'BY CLAimAkt�iti.rOTHE9'-CdUNtEt§�wg.'I_"-.'-tl�c-,R
County
Township
County
Township
I hereby certify the above statements are true, correct and complete.
Signature of claimant
Address (number and street, city state, ZIP code)
ASSESSOWUSE ONLY%_
MEN EN
0-TRUE-TAX-11
ASSES "--'
SE6.VALUE
A'
*,,;HOMESTEAD
I -
Q'-NOWRESIDENTIAL
;z4o4A0U"V-
0Z
/T TV�
%0
@WVALUEC-_
MR
OMR)4
Land not exceeding I (one) acre immediately
surrounding residential improvements.
Other land
(2)
Total land (line I plus line 2)
(3)
Dwelling
(4)
5M,
Residential Improvements or Annually
Assessed Mobile I Manufactured Home
Garage
A.
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus 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
D TI
STANDARD. EDUC OWALLOWANCE
AW
20 Pay 20 _
Lesser of 1/2 Homestead
valuation or 535.000
Signature of Auditor Date signed
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