Homestead_Haley (2)CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (RS I4 -03)
Prescribed by the Department of Local Government Finance
�Ld
FORM YEAR _
C10
INSTRUCTIONS: See reverse side for riling instructions. MAR 1 3 2007
CERTIFICATION STATEMENT', -q: : -. -= r,".`•" kr�'• .. - -..
(We) 'l�f.�1°aYL °SMejrh, 20
I (We) occupied as our principal place of residence the folloAlig described real property for which a Homestead Property Tax Credit is hereby claimed:
❑ 1 (We) owned ❑ Are buying under contract
0 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.
K CONTRACT.'.RECORDED�s_`',_.�t
If buying on contract, Fee Simple owners name
Recorders office where contract is recorded Record number Page
?'' 1:. , ROP, ERTY< l3ESCRIP. TIbN. ":•�ea`�irf_.,?�;�tr.T..W2 � R, - . aWv 6
County
Township
Taxing district (city, town, township)
(P I!y nber
�oO
Legal escrf
"^ d�ressss In bar treat, city, state, Z/ o )
� UU <�
Is the property in Question:
V J
Land not exceeding 1 (one) acre immediately);
❑ Real propeM ❑ Mobile Home Y.C. 6f.1 -7)
If any portion of the residential structure or the land exceeding one (1) ace that immedi lety surrounds that structure is used to produce income, describe the use and Portion
or the property utilized to produce income.
a &- /T -31- lot -000, t6 7 -009
•County
, TRUE TAX °
Township
County Township
I hereby certify the above statements are We, coved and complete.
S natur r cl marit
Aa
"^ d�ressss In bar treat, city, state, Z/ o )
� UU <�
�_
?b
^r YASSESSOR USE ONLY
MEN -' - i'+�, _
, TRUE TAX °
ASSESSED VALUE
r+
a HOMESTEAD
r iNIDN`- RESIDENTLAL,
v-.�„-t'�.Pu*`..z'C.:i Y s.,�+,*,;;gys -, tt'"`" ,�.
%'VA_LUErf {zF�µ
AT 100 %:OFiTfVg
�.VALUE')y'{s"VALUEt•3-
Land not exceeding 1 (one) acre immediately);
r`,#;v`.•r vqk �,
surrounding residential improvements.
(1i
n 1,
Other land
2
Total land (line 1 plus line 2)
(3)
Dwelling
'l,ytt��{ c 8
'Residential improvements or Annually
w)
.. . r•r v`�"i
F p 0
r� fAi
Assessed Mobile I Manufactured Home
Garage
(5)
SIR
1515
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 pits line 7)
(6)
1 hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
TANDARDM E000T )ON'ALLOWANCErp?„ %2i+1;^,t';.4a
20 _ Pay 20
Lesser of 112 Homestead
vatuauon or 535.000
Signature of Auditor
Date signed
STATE FORM 5351.111:11-n) TREASU l FORM 11A
AMYINED BY STATE.BORDCF ntTTXPTS.!,4 PECXNBm BY THE OF•ARP(LYT OFtreAE Gw<R.wren rEsscE ICH.I-'Y1.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples arc 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.
• HEA 1344-2109 requires taxpayers who reecho the homestead standard deduction to verify that they are eligible to reecho the
benefit and to provide additional identifying information neceszry to allow county government to better monitor horneste:Rl
filing,.-this information will he kept confidential and can only be accessed by autharired county officials.The Depannsent of
Local Government Finance will use this information to create mots that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Haley, Linda G
432 S West
Ilaubstadt IN 47639
8124
Linda G Haley
407E Church State Parcel Number Legal Description
HAUBSTADT IN 47639-8211
26-19-31-101-000.107-009 ELPERS NEUMAN 7
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PART2:TAXPAYER INFORMATION ,
Owner I First Middle Last
Lining G I4- ► c_ /4 I- L.rE y
g Address(number and street.city,state,and ZIP code) — — — — f'Same as property address —'— - — --
W4r9 C CHwp H Cr HI-1-URST ,4r1r Tl1/ 4763 ?
First Middle Last
Mailine Address(Number and street,city,stale,and ZIP code) ❑ Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
svz
: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.
Owner I 'manure Date
PART14:ADDITIONAL INFORMATION
S