Homestead_Buckn.
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (R614 -09)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing inslmctions.
FORM
HC10
YEAR
I (We) `y C._. certify that on the 1 st day of March, 20
I (We) occupied as our principal place of residence the following described real property for which a Homestead Property Tax Ciedit /is herebyai Ira /ed:
❑ I (We) owned El Are buying under contract
7-
—. t;neC;1 Ct't ;7111( ACOITCR t
Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the properiy or is buying under a contract.
s Esrd#nz�s� rte, �. ems as
''- 'CONTR.4CTRECORDEps _ `9'*.^13 IS%" %, . '-
If buying on contract, Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
-"S-4i
_ ",' >,> '_`.
.PR'OP,ERTY.OESCRIP,TION�';"` �-
County
Tamship
Taring district (city, to town ip)
Peel
.70 —000/ OOO / —OO
d n
;k �VALUE..�"?.s'�, �
s the property +nROal property ❑ Mobile Homo (I. C. 61. 1-7),
N any portion of the residential sW dare or the land of exceeding one (1) ave that infrnediakely surrounds that sdueture Is used to produce income, describe the use and portion
of the property utilized to produce income.
' A"'+' s.,'. �rFS +`PROP,ERTY,OWNED_BYCLAIMANT.IN OTHER "CUUNTIES+3,.�',I'33`�"sc ".%k
County
Township
County Township
I hereby certify the above statements are We, correct and complete.
t e claimant
d s (rwmber and street, dry, state, ZIP code)
(� 9 L' L- S 8 3
,g ts'g
r A SESSOR` E NLY. ;� r
N
X�r�
S TRUETAX
�y+—
ASSESSED•'"VALUE
°k�OF�TfV„
HOMESTEAD.
�> NON= RESfDENTIAL
�i+
,z + 2h &fa`„1!O$n3Y'rr� .... %
VALUE.'`s.. -,
:AT�100
;k �VALUE..�"?.s'�, �
ALUEr �. •��.
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
1
()
a....
Otherland
(2)
7
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
W ME s.
Residential improvements or Annually
Assessed Mobile I ManufaGUred Home
Garage
(i
5,'
Other improvements
(6)
t�
T 'F- 7?'
Total improvements (line 4 through line 6)
(7)
Trial value (line 3 plus line 7)
(S)
I hereby certify the above is We, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
20 _ Pay 20 _
Lesser of 1l2 Homestead
vauepW or 535.000
Date
spat FORM 53M tit:”.0.) MAS i[ER FORM 13-IA
.Ar?MwED BY Alt an&RD■ '•Y1R.'I.21.11, PAIS-Ina BY 111E DEPAnt-NT6 1G-At GOVELYMET'r FINANCE IC 6-1.1-2:4.1
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 dnWnion.As the receipt of this deduction becomes
more beneficial.there is more incentive than ever for homestead fraud.homestead fraud causer higher tax bills for all:therefore.
• ILEA 1344--2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to recehe the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.ibis infornutinn will he Opt conlidemial and can only be accessed by authorized county officials.The Department of
Local Goverment Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION
Taxpayer Name Property Address
Buck, Eleanor Louise
Isignzrestit
—__ ----Oakland Ciro IN 47660 , - - -
8393 -Co SS S. { I coLgsl
EleanorLBuck OAKL.).-t...t C.Tt
5055 S Lincoln St State Parcel Number Legal Description
Oakland City IN 47660-7659
�t�t t��ttt�t��rrt��tt��t tt�ttt�t��t tt�t�t�t�t tt�t�t t�t�t��t tt� 26-20-02-201-000.019-003 020-00019-00 MILLERS ADD 20/21/22/23
PART 2:TAXPAYER INFORMATION
Owner I First Middle - Last
LCKYloy J- ouIse, 6 ✓ c_. IL
tg Address(number a n d street,city,state,and ZIP code) -- ---- ❑ Same a s property address - — _ - — -- - — — - '-
o S 5 S. LlM c0 Lv• c1t CIAWLAN"A C iN1 -1`164 o
Social Security Number(last 5 digits) ' Drivels License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
sae
Spouse First Middle Last
Mailing Address(Number and street,city.state,and ZIP code) ❑ Same as properly address
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
0M M \ n u
Sptuse Signature Date Telephone r l
PART 4:ADDITIONAL INFORMATION
•