Homestead_HeadCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State roam 5473 (R715-015)
Prescribed by One Departowd of Local Coraanat Finance
INSTRUCTIONS: See reverse We for 6lurg instructions.
"� FoRa rEaR
HC70
P�F
I (We) -`fir n m, .� X �+� �C o i1.Si` certify that on st day of March. 20_
I (We) occupied as our principal p" of residence the following described real property for Homestead Property claimed:
I (We) owned ❑ Are buying under contract (r,0 7! COUNTY AUDITOR
Have a beneficial interest in the entity that is liable for the properly taxes on the property and that owns the property or is buying ureter a contract.
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�.4;:CONTRACTrREC mr%�,+"r.�K.,,. >..r rti ., s,.- ,.a,., ,rr (:• „.a~r.. r%l., .:xYs.
If buying on contract. Foe Simple owner's rams
Reorders dace where contract is retarded Record number Page
. t°s,''`,�i; •:Ji ,:'- PROPERTY DESCRIPTION...
Canty
Tavrchip
Tiodin9 d' (dY” Nwn. torwxVh P)
Parcel amber
Legal description
Ls the property in question:
/
1 - l to
_ --
3 s C Oa -rtJ �� D
[I Reel prop" ❑ Meta b Hare (LC. &1.1 -7)
IF any potion of the residential structure or the lad not exceeding one (1) acre that mrnedialety avnaxnd dud structure is usedploduce iworrne, describe the nee and portion
d the property di@md to produce income.
A aG- '10 -i�ja/- (r'0 / ".a- oaf
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. •r.r.1 a.w�.var.,a`j�1 • WQ Wwm /[LI1L�I�—IIl��
. _ _.',• .. a.. K • , , -: PROPEltff MNED BY,CLAMMT
t i "oTtlER COUrRIES ,...
County
Towns" .... _._....... _
Cony _. ._._
Township
I hereby certify the above statements are true, correct and complete. So-wad-nan,
0fes (nw9w and street, city, slam. IlPoode)
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3 s C Oa -rtJ �� D
}• `(, �`
,� TRUE -TAX '
ASSESSED VALUE
:HOtlFSTEAD
NoN4 ESIDENMLr
ASSESSOR USE ONLY,- i,'
'AT100%OlF TTV
nom', ";YAWE.�.p
Land not exceeding 1 (one) eve irtmedialely
snarwmdirg residential
Other lard
2
Tdal lard (tine 1 pies &ere 2)
(3)
m or
Residential bnproveents Annually
Dwelling
(4)
Garage
r r �w - -: » ..-r- • z ;
Assessed Mobile I Manufactured Home
5!>a
Other bnproverrhenLS
(6)
IV
Total vnprove neMS (here 4 through 6ne 6)
(T)
Ti tar' value (/me 3 joke One 7)
(s)
1 hereby certify the above is true, correct, and
Sowtu a of Assessor
Date signed
complete.
VoWng action - Souduia afAUdmr
Date signed
®). t'.h + r:. va' Y^. H" f( "STfWDAiiD.DEDUCTION'AC.LOWIWCE `J .art t'A5 7 .c8a °,? a,"„<"yc•
20 _ Pay 20 _
Lasser of 12 Honestead
$
Valuation or $35.000
Signatwe of&dtor
Date signed
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STATE FORM 5350001 LIB) IREAA9kl FORM TS-IA
• APPROVED BY STATE BM0.0 OF ACCOUNTS 20:0 PRFXRIBFD BY THE OFYARTMECT OF LOCAL GOVLA\MEvr FlMA•13 IC 1.1.1-2111
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 beneficial,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
• benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will be kept confidential and can only be 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 I: PROPERTY INFORMATION
Taxpayer Name Location Address
Head, Paul L Jr/Kellie M
7166 S DIVISION
MACKEY IN 47654
9 .
Paul L Head Jr: 1111 11111.11111111111111111 1111111 II I II LII II II 111111 1111011111 II I I II •
7166 S Division
OAKLAND CITY IN 47660-7748
Illllllt IilIIiiilil' 'I11III1111"i1'il'li'llll1lll'11II"I111'I' State Parcel Number / Legal Description
--- -- 26-20-14-301-000.100-002 /PT NW SW 14-3-9.39 AC
•
•
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.
A - - - PART 2: TAXPAYER INFORMATION
Owner I - First Middle Last
/1
i 4L LI5Li6 ff61A ✓'�.
Mailing Address(number and street city.state,and ZIP code) 121Same as property address
'7/(06 I biViS/oi) Cr. / of4IAJJ8 CITY 3 1 N 4766O
Spouse First Middle Last
KELLIE HiemEiI_ 1-I1.AD
Mailing Address(Numbcr a eeC eity;state,and ZIP code)-- — -- -- — Same as property address-7't4 5, 1 ivisloiJ ST Oak1AND CITY ; 1 n) 476Go
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 Si true Date
PART 4: ADDI'T'IONAL INFORMATION ,/