Homestead_Boes %TArr DORM rs•n n;AM VLF-Anita'ORM TS-IA
.YYdxED BY STATE}WARD A(rrttsra.:un rtrsRIDm BY Till DE PARTe 4T(IFL(AALrovELYMrNT FINANCE
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 eser for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
0 HEA 1344-2009 requires taxpayers who reccise the homestead standard deduction to verify that they are eligible to recent the
benefit and to provide additional identifying infomunon necessary to allow county government to better monitor homestead
tilintg.This information will he kept confidential and can only he accessed by authorized county officials.'Be Depantnenl of
Local Gosenvnent Finance will use this information to create t.Vls that will hrlp county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Bees, John L/ Kelly
208 S Vine
Ilaubstadt IN 47639
3116
John L Bees
208 Vine St State Parcel Number Legal Description
HAUBSTADT IN 47639
26-19-31-303-000.435-009 013-00435-00 ORIGINAL PLAN
235236/237
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 1 First Middle Last
v 0r) L.-eager �D�S
Sig Address(number and street,city,state,and ZIP code) p-ame as property address
ADg S . Vine S-i. Wa b& e,ig , IMLf-j& 3ei
Spouse Fitt A Middle Loa
< (
Mailing Address(Number and street,city,state,and ZIP code) aSame-as property address
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
unla a• ., e or she/may be liable for back taxes and substantial financial penalties.
Owner I Signa / Date
110: PART 4:ADDITIONAL INFORMATION
CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
t CREDIT /STANDARD DEDUCTION
i HC10
State Form 5473 (R6 14-03)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filinq insrmrlions.
I (We) certify that on the 1st day of March, 20_
II (We) O pie our principal place of re idence the (ollowi crt eat property for which a Homestead Property Tax Credit is hereby claimed:
I (We) own ❑ Are buying under contract )- �
Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is burying under a,trac
If buying on contract. Fee Simple owners name
Recorder's office where contract is recorded
Record
ePR0P.Ek7"4bWNEDiBY CLAIMANT J
;IN�OTHEWCOU TiES
County
Township
Taxing district
nu ben
W35-
escri bon
P
Is the pr pert/ in question:
6
TRUE TAXX i
1' __
eat property ❑ Mobile Home (W. 6f.1 -7)
any Portion of the residentlal 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 utilbed to produce income.
ePR0P.Ek7"4bWNEDiBY CLAIMANT J
;IN�OTHEWCOU TiES
County Tmnship
County Township
I hereby certify the above statements are true, correct and complete.
Sign Gaim
Address (number and street city, stare, 71P code n
Is
#r.- :.?� -3 � r
yAS$ESSORUSE ON Ko-
TRUE TAXX i
1' __
ASSESSED�VALUE
4-;HOMESTEAD -
j NIRESIDENTIAL �
..��c.'.': z
VALUE
Land not exceeding 1 (one) acre immediately
°�1�•q- +�- `r�z`"»
surrounding residential improvements.
Other land
(2)MINN.
�,
Total land (line 7 plus line 2)
(3)
Dwelling
(4)
Residential improvements or Annually
Assessed Mobile I Manufactured Home
Garage
(5)
Other improvements
(g)
> = i =
Total improvements (line 4 through line 6)
(T)
Total value (line 3 plus line n
(6)
1 hereby certify the above is true, corned, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
of Auditor
20_Pay 20_
Lesser of 1/2 HomestE
valuation