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Homestead_HarkerCLAIM FOR HOMESTEAD PROPERTY TAX ^p,� YEAR CREDIT FORM STANDARD DEDUCTION r` HC10 State Form 54473 (R6 /403) Prescribed by the Department of Local Gmemment Finance INSTRUCTIONS: See reverse side for filing inslnrctions. I (We) (D certify that bnithe' 1st d�ytlttMarch, 20 (We) occupied as our principal pla sidence the following described real property for which a Homestead � Property �Tax Credit is herre�eby daiaimed: ❑ 1 (We) owned ❑ FVe b � under contract �^ -�'�! J1 Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns.theproperty Ur ts'buying,under'a,contract. ',fi` flN1i;S °�'siEe Jr'"�,1Y ?ter- ?ILC.^1f' < y u -; ONTRAC �ss���ic T.=RECORDED�` Ft'r x�, If buying on contract, Fee Simple owner's name Recorder's office where contract is recorded Record number Page P.____. ROP ,ERTV:OWNED`,BY�CL'AIMANT,IN' OTHER 'COUNTIES- r.`�.�,_���. ' ?P,ROP.ERT.Y.DESCRIP.TION!*e-V;7r ?? zr.. ?-' mftw� Cou ty Tonnship hereby certify the above statements are true, correct and complete. Taxing district (city, to , t nship) dress (number and stree/tt, city state ZIP code) , ti Ofrn 700% OF�TTV ,�3: VALUE.. r .'s- Pa nupU7eWoot _ `LJ, —N L des 'o 11)- Is the pro in esUon: I property ❑ t+loWle Homo (LC. 61.7 -n If any portion of the residential structure or the land not exceeding o of the property utilized to produce income. If acre that immediatey wrrounds MI structure is used to produce income, describe the use and portion P.____. ROP ,ERTV:OWNED`,BY�CL'AIMANT,IN' OTHER 'COUNTIES- r.`�.�,_���. County Toomship County Township hereby certify the above statements are true, correct and complete. Oignature of d ant dress (number and stree/tt, city state ZIP code) , ti Ofrn '1 AS$ESS�OR EON Y�-x "TRUE -:.. TAXy ASS ESSEDVALUEHOMESTEADt NONRESIDENTIAL i. _ r'F'r +A,r^•^yn��.- its�`„""s.�„s 07 +VALUEr"Yl.><�Z..:AT 700% OF�TTV ,�3: VALUE.. r .'s- Fcr••d':.:�..VALUE...4,ss�? Land not exceeding 1 (one) acre immediatelyr- 11)- surrounding residential improvements. Other land (2) ftra`x.£a�:ti Total land (line 1 plus line 2) (3) Dwelling (4) A';- 2 Residential improvements or Annually ` F �' Assessed Mobile / Manufactured Home Garage (5) _� VMS r.e�� Other improvements (6) :y�y ;• ---]]] Total improvements (line 4 through line 6) (7) Tdal value (line 3 plus 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 20 _ Pay 20 _ Lesser of 112 Homestead _ Valuation or 535.000 or 0 AMAZE FORS'M MIL'/betel .. n Mnhr I FOLM 7-IA Ar/ROVED BY Milk IM OOf NW:13.1a PLEMBEm BY Mt DEPARTME`IT(FLOAL C.IntRYMlTf FINANCE IC V1.r1'-1.1 Gibson County Auditor 101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS PRINCETON IN 47670 IndividuaLs and married coup) ,are limited to one homestead standard deduction.As the receipt of this deduction becomes more beneficial.there is more incentive than ever for homestead fraud homestead fraud causes higher tax hills for all:therefore. • HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to recei.e the benefit and to provide additional identifying information necessary to allow county government to better monitor homestead filings.This information will he kepi confidential and yen only be accessed by authorized county officials.The Department of Local Government Finance will we this information to create tools that will help county officials eliminate homestead fraud. PART 1: PROPERTY INFORMATION Taxpayer Name Property Address Harker, Timothy D/Suzette M 101 N Campbell BLVD Ilaubstadt IN 47639-8 1 63 2693 Timothy D&Suzette M Harker 101 N Campbell Blvd State Parcel Number Legal Description HAUBSTADT IN 47639-8163 'I I n I I ni r I I n .I I I u u I n,I t I I n _I i I I i 11111111 26-18-36-401-000.631-009 013-00631-00 WEST HGTS 4TH ADD 9 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 v Last �_g Address(number"and street.city,state,and ZIP code) El Same as propene address �0/ ,rr e otie// 3x0 / 61 s-7-4orJ z� v76 37 Spouse First Middle Last LS:/2 c77e /'///L/Y'i_ idel e Mailing Address(Number and street city,state,and ZIP code) n Same as property address /0%/eA0,Ae//W1101/ lidSTn�r-c/ x/7439 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 liable for back taxes and substantial financial penalties. Owner I Signature Date / PART 4:ADDITIONAL INFORMATION •