Homestead_HarperCLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDIT /STANDARD DEDUCTION HC10
State Form 5473 (RS 110-01)
Prescribed by the Department of Local Govemment Finance
INSTRUCTIONS: See reverse side for filing instructions. PIT,
WIWV-IftO§WtW��=�-'CERTIF I CATION STATEMEN
I (We) V certify that on MAt 20
1 (We) occupied as our principal place of residence the foulng describid real property for which a Homestead PToDerty Tax Credit is hereby claimed:
❑ 1 (We) owned ❑ Are buying under contract
ffir--1 Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns thj;�ar �ls��y,4�g Andegir4,pra
,La� n ct.
-NTRACT�'RECORDED
If buying on contract, Fee Simple owner's name
Recorders office where contract is recorded Record number Page
County
Township
If any portion of the residential structure or the land not exceeding I acre
of the prop" utilized to Produce income. t7l-(N
� - co,:4.oa/q3 -W 1�r
Taung district (city, town, township)
Is the property in question:
❑ Real property ❑ Mobite Kerns
used to produce inoonne. describe the use and portion
— ` 'I
20 _ Pay 20_
Lesser of 1/2 Homestead
Valuation
Signature of Auditor
County Township
County Township
I hereby certify the above statements are true, correct and complete.
Sig I aunant
&M&
• Ad as (number and street, cdy, state, ZIP cod
3m) zV '1709
ONLY
'1211 W-11 ME,
ASSESSED VALUE
_--HOMESTEAD
b NOWRESID64ilAO---
4�a�W�
51 YIS�YE N 1
V
XF-,�
MVAL
I U U g-
- -�-S - -
�VALUEW`
Land not exceeding I (one) acre immediately
IR
surrounding residential improvements.
Other land
(2)
Trial land (line I plus line 2)
(3)
Dwelling
(4)
Residential improvements
Garage
(5)
RON,
RNOther
improvements
(6)`
-v N1
Total improvements (fine 4 through line 6)
(7)
Total value (line 3 plus line 7)
(8)
I 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 1/2 Homestead
Valuation
Signature of Auditor
slAtE FORM.YtFIR /'-& I MALUtil Po0.4:I-IA
ArrRVA'rn BYclkIE BOalinHMVCR;.STS,Y,n PRr1WarP BY 7111"BPPARTMET OF L OAL GOVEFNMLNT rPANCEIC♦I.t-L''tl
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 ever for homestead fraud.homestead fraud causes higher tax bills for all:therefore.
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they am eligible to recene the
benefit and to provide additional identifying information nece.saly to allow county government to better monitor homestead
tilings. This information will he kept confidential and can only he areeesed by authorized county officials.The Depannem of
Local Government Finance will use this information to create coals that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Harper, Eric W/Shona J
Laurel Ridge Court
—- - - - - -- — -- - - ._ - --_ - IIAUBSTADT IN-47639 -_
8300
Eric W Harper
300 S 6th Ave State Parcel Number Legal Description
HAUBSTADTIN 47639-8213
26-19-31-400-000.703-009 (65 RWOOD I8/Briarwoaf 1143 W 1/2
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
_ Eric ( h-C, 4 our vstr
ng Address(number and street,city,state,and ZIP code) -— -- -- 'time as propcny address - — —
3oo S. (/" Ave, iia�lhsk�sl . XTM 44 39
-
Spouse First Middle Last
S 0.6z. gay pet
Mailing Address(Number and street,city,state,and ZIP code) l yl Same as property address
300 S. (.0‘4' Ave• al,;hsh f. SN 1/&3C
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.
atu Date
PART 4:ADDITIONAL INFORMATION
•