Homestead_HodgenCLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDIT/STANDARD DEDUCTION HCto
State Form 5473 (R5 I 10-01)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for riling instructions.
-.'CERTIFICATIO"TATEMENT,-
I (We) _Zk &f6m if I y n t e s dly�f AUPK 20
I (We) occupied as our principal place of residence the f4wing described real- prop 6oy which a omestead Pr erty�T Tax it ijisrelby cle
LJ I (We) owned ❑ Are buying under contract PT
I _ 0
P&to
(" in TOR
(TV AIITTPR
Wave a beneficial interest in the entity that is liable for the property taxes on the property and at owns the p&�60bitQq;4under a o ract.
CCONTRACT.!RECORDED ' -: ,—i : ,� "!�,W
If buying on contract, Fee Simple owners name
Recorders office where contract is recorded Record number Page
PROPERTY OWNED 'SY CLAIMANT ibiOTHER'COLfi4TIES
PROPERTY 6ESCRIPTION
County
Township
Taxing dist t y
wn, ownship)
Pant
/S ber -7-0
Legal description
Is the propy(ty
in question:
-00o&C
VALUE_ -_
�Tjq(1016
-t
❑ Real property ❑ Mobile Homo (I.C. 6-1.1-7)
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.
J-
PROPERTY OWNED 'SY CLAIMANT ibiOTHER'COLfi4TIES
m
County
Tmnship
County
Township
I hereby certify the above statements are true, correct and complete.
Sin of cl imam
'ress (number and arrest, Zo,;P code)
V
-/ 71,.5 -,el
0
z
TANDARD.DEDUCTIONALLC)WANCE-'--.v:
20 Pay 20 —
Lesser of 1/2 Homestead S
Valuation or $6,000
Signature of Auditor Date s V3 Id - D<4,—
RU -E'f
ASSESSED VALUE VALUE
-4:
NONRESIDENTIAL.
SSE USE
OFTTV�
-'erHOMESTEAD
�f -'VALLIEXV,2�
VALUE_ -_
�Tjq(1016
-t
f4L,;,!-r
Land not exceeding I (one) acre immediately
surrounding residential improvements.
Otherland
(2)
Total land (line I plus line 2)
(3)
Dwelling
(4)
Residential improvements
Garage
(5)
jq!
Other improvements
(6)
S
Total improvements (line 4 through line 6)
(7)
Total value (fine 3 plus line 7)
(8)
I hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
z
TANDARD.DEDUCTIONALLC)WANCE-'--.v:
20 Pay 20 —
Lesser of 1/2 Homestead S
Valuation or $6,000
Signature of Auditor Date s V3 Id - D<4,—
• STATE FORM 5350(Yllt-10) TREASURER FORM TS-IA
APPROVED BY STATE BOARD Of AL-COMM.Y . FRESCRIBF➢BY TIE OEP.ARTN.ST OF LOCAL COVEXNMEYT FINANCE IC-Lt-fl2.1
Gibson County Auditor IilIPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N.Main Street ' Individuals and married couples are limited to one homestead standard deduction. As the receipt of this deduction becomes
Princeton, IN 47670 more beneficial,there is more incentive than ever for homestead fraud.Homestead fraud causes higher tax bills for all;therefore,
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
0
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will be kept confidential and can only be accessed by authorized county officials.The Department of
FiL ED Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION
Taxpayer Name . : - Location Address
APR 1 6 Hodgen, Helen//
C.�
Clifford & Barbara
C9l - •950E
MACKEY IN 47654
G/gam
COL:7N ,
II I0111_111111 II 111111111-.111111111[IfllflUi _ILIII[1-1111111 1111110111 IIIni II Helen/Clifford Hodg2QRBarbara Bolin
PO Box 63
Mackey IN 47654-0063
II'III"'I'VIII'III'!Ills'11'lIl'Illl'Illlllllll'tlll1ttllll�l�'I State Parcel Number Legal Description
26-20-15-402-000.027-00$ 'PT ESE 15-3-9.88 AC
. 165 ` 5 D
fn
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.
— - PAR1'2:_ A PA.YEitzi-OR,ALATJO\__- _,-
Ow,.,.r t - - First . Middle - Last
s
Mailing Address(number and street,city,state,and ZIP code) ❑ Same as property address
Qo goy. to 3 = Mack £17 Xi 4771, 6 ,1 -
` -
Spouse First Middle Last
X77'ACOrei JA__), dloketo
m
Mailing Address(Number and street,city,state,and ZIP code) 0.Same as pm address
CSkPl€ /4 5 4j Oar . •
.
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 Signature Date