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CLAIM FOR HOMESTEAD PROPERTY TAX FORM
Y � YEAR
CREDIT /STANDARD DEDUCTION HC1D I^
State Form 5473 (RS 110 -01)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
I (We) / / /Cif// = p certilthat &AhPTsi day of March, 20
I (We) occup' as our pdncipal place of residence the owing described r property for which a Homestead PropeOTT (�e�t (��lby claimed:
❑ I (We) ed ❑ Are buying under contract j�f 1ICC
r Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the p/6Derty or is bAyingil////((77 'der a couff U.
If buying on cenbacl. Fee Simple owners name
Recorders office where contract is recorded
Record number ( Page
._ -' - _
P, RbP. ERT, Y.:DESCRIPTIONt�:.'- �,.h =:ra` o,''s.- .- =•„''- R- 'tas -'.
County /
Tounsh
Tavnship
Taxing district y, town ownnsh' )
Signature of claim
A
t�1`
P dress (numberand street, city, state, ZIP code)
i/Y S N N
-E-K)
Parcel number 2
3 /BOO
Legal s 'ption
Is the property in qu lion:
^' �Q
surrounding residential improvements.
Realproperty ❑ Mobile Home(I.C. 61.1 -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.
Other land
'o. w
s."i�'-'ts ?nFl �i a;�z>3 =;> . wEPROPERTY ,OWNED;BV'CI'AIMANT,IN OTHER'COUNTIES c"., .- (5 �- `""+ -. �'V
County Towns hip
County
Tavnship
I hereby certify the above statements are true, correct and complete.
Signature of claim
A
t�1`
P dress (numberand street, city, state, ZIP code)
i/Y S N N
-E-K)
�t s
.�Y-r �'= ASSESSOR USE ONLY �
� RUE TAX
ASSESSED VALUE
r HOMESTEA- -
NrONtREStDE TIALYr' {
�
�?`,`....�
''rtr��'..YAL_UEY �
yAT4100 /OFtS T.s.,va'�c
VALUE.
VALUEK'
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
Other land
(2)
K,«; s
�FyyA44
r,�f
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
rowi
G �' -s'
-T-". `"`'' 1-
Residential improvements
Garage
(5)
.I Sr
K����? .
Other improvements
(6)
'e
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(S)
1 hereby certify the above is We, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
'i ifj :kia .:Mt-bM+ STANDARDDEDUCTION`ALLOWANCEi >rc' 4.� =s 'c ;�'1,�.:!i 4^`, - rem- "°s.�?�G ?is'k,.�•.._�"
20 _ Pay 20 _
rVerof 112 Homestead
.
aluo gr $6,000 $
I
Signature of Auditor Dae igned/
VIM r ts'`3rn.IR/s,nm IPE.1SUtER FORM 73-IA
APPIttWE°By sr MT.OIwnnr MvvxL\TS.29" PAISTIBFWDY r11r DEPARiWVTOF LOCAL OO?FXSIFIR FNASCE ICLI.I-t-t.l
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than ever for homestead fraud.Ilonlesrcnl 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.'Ibis information will he kepi confidential and ran only he accessed by authnrved county officials.The Depanndml of
Local Government Finance will use this information to create twls that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Allen, Ryan N/Jami L
114 S Vonna LN
Ilaubstadt IN 47639-8 13 1
2717 • .
Ryan N Allen
114 S Vonna State Parcel Number Legal Description
IN
HAUBSTADT IN 47639-8131
26-18-36-403-000.431-009 013-00431-00 WEST HGTS 2ND ADD 114
IIIttlltttIIllttttlltIIlttlttlttttllttllttttlltttllllttltlIIII A
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 Lasl
Rv14 /4 Al Allen/
08 Address(number and street,city,state,and ZIP code) tom, Same as property address
IIy .S . Von ria. La. f-lAubs-f 1f ZN LI 7639
Spouse First Middle Last
(TAMS L t .41len/
Mailing Address(Number and street,city,stale,and ZIP code) 0 Same us property address
1Iy 5 , Von ca ILti. l-E4ubs-h4M-f 47039
- - --_�-- - -
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
PART 4:ADDITIONAL INFORMATION