Homestead_Field -
SLATE FDRN'!!n+IR:INnr _ T lASURFR rgL43IA
Anlrtn'E0 BY Sff1E MIARDOL ACCOUNTS.:WM PRF_YRmm BY Mr OEPMTheC OF LOCAL GOVERNMENT MANCE M 41.1-r-tI
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited l0 one homestead standard deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than ever for homestead fraud I lomesread fraud causes higher in 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 Try-4 confidential and can only be accessed by authorized county officials.The Ihlanntent of
Local Government Finance will we this information to create tLVls that will help county officials eliminate hRncACal fraud.
PART I: PROPERTY INFORMATION
Taxpayer Name Property Address
Field,Angela J
105 S Eileen ST
llaubstadt IN 47639-811
2735
Angela J Field
105 S Eileen State Parcel Number Legal Description
HAUBSTADT IN 47639-8114
1ulrr1Iurrlullurt ullrlt teeter lrr rr llr rt llr'rr'llt lit ll ll rlt It 26-18-36-404-000.195-009 013-00195-00 PT SE 36311 LOT 105
._ _. _ ___ __ - - __ . _ _ _ _ — _ . - _ _ _
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 Last
MSC,t4.- IC)1c..ne. 1--I e col
to Address(number mid street.city,state,and ZIP code) Et Same as property address
105 5. Eileen :c Lt1 (. 3c)
Spouse First Middle Last
(JIp I (4
Mailing Address(Number and street,city,stale,and ZIP code) Same as property address
Social Security Number(last 5 digits) .vds License/State ID Number (last 5 digits) Other(please specify in Pan 4 below)
__ _ _. . —_ _ sae
-/ PART 3c 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
0
CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEA
CREDIT /STANDARD DEDUCTION Hc�o
State Form 5473 (R6 / 4-03)
Prescribed by the Department of Local Government Finance
I (We) ceni(y yipt (R t5i 2tny of March, 20
1 (We) occupied as our p ' 'pal place of ence the following described real property for which a Homestea roperty Tax Credit is hereby claimed:
TZPI (We) owned ❑ 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 buying under a contract.
CONTRACT=RECORDEO`r�'
If buying on contract, fee Simple owners name
Recorders office where contract is recorded Record number Page
°.1'siSq++. -Y.6 -_. �.c,.x- ir.�.ry ,.rns..- -,r.., ryz..::x..,.a
iYJ tPr •• �+ -...
'4#
-.rt•, P,ROFERTY.DESCRIPTION t..,.._..>�.-
County
Tomship
Township
Taring district (city, town, township)
Parcel number
Leg�attJ$escdption
Signature of laimant
Is the property in question:
0/ 3 — 00 Q�
r
/
(p
eal property ❑ Mobile Home (/.C. 61.1 -7) .
H any portion of the residential structure or the land not exceeding one (1) acre that immediate y surroun t structure is used to produce income. describe the use and portion
of the property utilized to produce income.
- .x_'-x <.'��`� -f ` c-' �A7� -T�- a'?�'✓r�PROP.ERTY.OWNED';BY CLAIMANTJIJ
OTNER "COUNTIES fk�"?.� ^;a��°i._
.t- "5.,`i,:�. : -.; fi
County
Township
County
Township
I hereby certify the above statements are true, correct and complete.
Signature of laimant
Address (number and street, city, slate, ZIP code)
surrounding residential improvements.
*?�`� ASSESSOR SE ONLY 't?r+°-
D,i TRUE-TAX, a'
ASSESSED VALUE
'HOMESTEAD'^J
NONE; - RESIDENTIAL.
C .'*r� 'dwSS VALU "�.-r. sL
Land not exceeding 1 (one) acre immediately
Valuation or 535.000
Signa o
surrounding residential improvements.
VVI
Other land
Total land (line 1 plus line 2)
(3)
Dwelling
(4)?zs�.-
lRasidential improvements or Annually
''
Assessed Mobile I Manufactured Home
Garage
(5)
Other improvements
(6)�"�'+�
-%'
Total improvements (line 4 through line 6)
(7)
Trial value (line 3 pits line 7)
(0)
1 hereby certify the above is true, correct, and
Signature of Assessor
Data signed
complete.
Verifying action - Signature of Auditor
Date signed
... '� t`•r m. -��_ r=" „gSTANDARD'DEDUCTION'ALLOWANCE.,
qW 20 _ Pay 20
Lesser of 112 Homestead T$
Valuation or 535.000
Signa o
Date igned /