Homestead_Loveless (3)CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
s CREDIT /STANDARD DEDUCTION HC10
State Form 5473 (R6I1 -03)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for Kling instructions.
I (We) f.certity that on "the lst day Mar
I (We) occupied as our principal place of residen he following described real property for which a Homestead Property�T CCredit /.iswecA{y claimed:
-� �' ,
�\ I (We) owned �re buying under contract - ' 0,, 4TV 4,UDIT09
Have a beneficial interreeal in the entity that is liable for the property taxes on the property and that owns the property or is buying under a contract.
F"ct?VZ -�WW` ?1. '''., s' -.0 CO NTRACTRE_C_OR_UEU
If buying on comr-dct. Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
PROP ,ERTY.DESCRIP,TIbNiR�+.'xc
County
Township
Taking district (city, town, wnship)
Parcel number
Legal description
Is the mperty in question:
j ASSESSORUSE ONLa
TRUE TAXr `
�VALUE3r
eal property ❑ Mobile Home (I.C. 6-1.1 -7)
If any portion of the residentlal structure or the land not exceeding one (1) acre that immediately surrounds that stru re is used to produce income, describe the use and portion
of the property ti faed to produce income.
r
DARDiDEDUCTIONALLOWAIiCE „ a: u� ,g M:_��Tl"�- �- ?y�"'V��.'. `-�.
County Township
County Township
I hereby certify the above statements are We, correct and complete.
Signat e f claimant
ress (number and street, city; scat IP code)
j ASSESSORUSE ONLa
TRUE TAXr `
�VALUE3r
ASSESSED VALUE
=ATys100 /o OFTTV
rHOMESTEADr_:.
VALUES`
?2.—.� ....�?
dy _Qt ONON N41ESIDENTL4L
VALUEKe
7 -i.'t.
Land not exceeding 1 (one) acre immediately<"iy
surrounding residential improvements.
Other land
(2)
fF w_'t_ F3'3F'
.,1�
_10
Total land (line 1 plus line 2)
(3)
Residential improvements or Annually"`°'`
Assessed Mobile I ManuhaMred Home
Dwelling
Garage
g
(4)'1,
(6)3�aa�'�����;tiR�
-a5
sN 3s
Other improvements
(6)
Total improvements (line 4 through line 6)
(T)
Tdel value (line 3 plus linen
(6)
I hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
Verifying action - Signature of Auditor
Date signed
DARDiDEDUCTIONALLOWAIiCE „ a: u� ,g M:_��Tl"�- �- ?y�"'V��.'. `-�.
20_Pay 20_
Lesser of 112 Homestead
Veluabon or 535.000
I
Signature of Auditor
D ate signed
5
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MATE FORMfl5f•,nt%■Pil IAFAS1i1M FORM DS-IA
I . APPROVED BY MATE BOARD OF ACOr tSTW PREYVIDED BY THE DEPMMEYT OF LOLL novaMMrsr FINANCE MH.I-E:-,.,
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 dds deduction becomes
more beneficial,there is more incentive than ever for homestead fraud.Ilomestead fraud causm higher tax hills for all:therefore.
• HEA 1344-2009 requires taxpascrs who receive the homestead standard deduction to verify that they are eligible to receive the
benefit and to provide additional identifying information nemsary to allow county government to better monitor homesead
filings.This information will be kept confidential and can only he accessed by authorized county officials_The Depannrent of
Local Government Finance Brill use this information to create tools that will help county officials eliminate homestead fraud.
. PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Strickland, Linda C Life Est Trust •
R3 Box 146 A
Oakland City-IN 47660 - __
8649
Linda C Strickland
do Donna Loveless
P O Box 260 State Parcel Number Legal Description
SOMERVILLE IN 47683-0260
IJrrIL,,I,IIttL,Ii,,ILlLttttIJlIL,IIiiiJlttlIiiiIi Iif 26-20-14-303-000.079-002 015-00079-00 PT SW SW 14391.00 AC
Q/1 t/ t Ve 7'h6 SDi (/i5i0nS
4. (Onto ., eti.,4 , L/7644
PART 2: TAXPAYER L FORMATION `
Owner I First (� Middle ) ,(� �� Last
Ong Address(number and stmt,city,state,and ZIP code) nn ^— U Same us piopert ouibtss
?X �,1 oO o oyy2 A UCUQ cQiyj'
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Pan 4 below)
s1@
, PART 3:.CERTIEICATION
-- 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 homesteadstandard 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.financialpenalNies.
Ow I Signatl I �L\ r, t1 Date Telephone
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Spouse Signature Date Telephone
( )
PART 4:ADDITIONAL INFORMATION ,
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