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CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Forth 6673 (R817 -07)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
FORM YEAR
HC10
ILED
I (We) a�AAVL-'W�ITLXAP'C> bm �YJ f \ certify that on the 1st day of March, 20_
1 (We) occupied as our principal place of residence the following described real property for which a Homestead Pro hereby claimed:
;I(We)owned ❑ Are buying under contract GIBSON COUNTY AUDITOR
Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is buying under a contract.
y a.�'['....a .. ,��. a,� `... :.. -_CONTRACiRECORDED. > =;�
If buying on contract, Fee Simple owner's name
Recorder's office where contract is recorded
County I Tomship I Taxing district (city, town, township)
Is the property in question:
❑ Real property ❑ Mobile Home (IC 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.
R
County I Tovnship I County
I hereby certify the above statements are true, correct and complete.
HEM
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Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
Other land
(2)
Total land (fine 1 plus line 2)
(3)
Dwelling
(4)
,
Residential improvements or Annually
Assessed Mobile I Manufactured Home
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus fine 7)
(8)'
I hereby certify the above is true, correct, and
Signature of Assessor
Dale signed (month. day, year)
complete.
Verifying action - Signature of Auditor
Date signed (rrmnN, day, year)
20pay 20
Lesser of 1l2
Homestead Valuation
or
45,000 for 2007 pay 2008 42,000 for 2010 pay 2011
44.000 for 2008 pay 2009 41,000 for 2011 pay 2012
43,000 for 2009 pay 2010 40,000 payable after 2012
MATE FORM!MM IIL'/'a«I IRLSnall FORM Ts-IA
.AFrKOVFP DT lisIE MNRDOEMYI.t%7.9.Y PErrRaBED BY an DEPARTMENT(W REAL rVERm417.'7 FINANCE ter-1.1_`-1.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individua6 and married couples are limited to one homestead :unclad deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than ever for homestead fraud.Homestead fraud causes higher tat 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 he Aryv conlidenlial and can only be accessed by authorized county officials.The Department of
Local Government Finance"ill use this information to create tools that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION
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Taxpayer Name Property Address
_ Beloat, Genevieve
521 S 8TH AVE
Ilaubstadt IN 47639
10818
Genevieve Beloat
521 S 8th Ave State Parcel Number Legal Description
HAUBSTADT IN 47639-8237
I I't t l l t t t l r l l r t t t l l t'f l i t't t l t t t I lrr lr lrl tlllrtl ll 26-23-06-200-000.791-009 ALTE DEUTSCHE STADT 2 UNIT 1
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
CCMEV1 EVE 4 . 4-0 pi
irg Address(number and street,city,state,paid ZIP code) Same as property address -- - - - -- -
521 Sour' r At"- R-VE. }-.{ RLA-bSTf}-aL7 / I� '17& 3 7
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 Liccnsc/State ID Number (last 5 digits) Other(please specify in Part 4 below)
Scut
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.
er I Signature nn Date
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