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Homestead_HayesA ary CLAIM FOR HOMESTEAD PROPERTY TAX F M Y R CREDIT /STANDARD DEDUCTION o State Form 5473 (R2 / 5 -92) x INSTRUCTIONS: See reverse side for filing instructions. ,�,// /�• CERTIFICATION STATEMENT _ _ certify that on the 1 st day of March, 19 pied as our principal place of resid ce the following descri real property for which a Homestead Property Tax Credit is hereby claimed: I)(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 RECORDED - It buying on contract, Fee Simple owner's name Recorder's off ice where contract is recorded Record number Page PROPERTY DESCRIPTION County Township County Taxing district (C//, town, township) Parcel number 613 - 00a Legal de ;pion 4kQdd � % It any portion of the residential structure or the land not exceeding one (1) of the property utilized to produce income. that immediately surrounds that stn.,, ure is used to produce income, describe the use and portion PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES County Township - County Township eby certify the above statements are true, correct and complete. gn •ure of claimant Add s (number and street, aiy, state, ZIP code) y 9 ASSESSOR USE ONLY TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL VALUE Land not exceeding 1 (one) acre immediately surrounding residential improvements. (1) Valuation or $2.000 Signature of Au . or Other land (2) // Total land (line I plus line 2)) (3) Residential improvements Dwelling (4) Garage (5) Other improvements (6) Total improvements (line 4 through line 6) (7) Total value (line 3 pbs line 7) (6) I hereby certify the above is true, correct, and complete. Signature of Assessor Date signed ring action -Signature of Auditor Date signed STANDARD DEDUCTION ALLOWANCE 19 —Pay 19_ Lesser of 1/2 Homestead S Valuation or $2.000 Signature of Au . or Date sign // � n atAtt Rita,aya,R'/ tN.ssuRFR FORM 1IA A rennn'lo or MAIL moan(W!flt.N75.m+ PRr:n=0DV alt DEPARTMENT OF LOCAL fovT 'MIWr nI:A%rE a V1.1-r!.1 Gibson County Auditor 101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS PRINCETON IN 47670 Individuals and married couples are limited to one homestead standani deduction.As the receipt of this deduction becomes more beneficial.there is more incentive than eter for homestead fraud.Ilonnsread fraud causes higher has bills for all:therefore. • HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to serity that they are eligible to reethe the benefit and to provide additional identifying information necessary to allow county government to better monitor homestead filing.This information will he Amt confidential and©n only be accessed by authorized enmity officials.The Ikpanntenl of Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud. PART 1: PROPERTY INFORMATION Taxpayer Name Property Address Hayes, John P/Cindy E 103 N Campbell BLVD Ilauhstadt IN 47639-8163 7280 John P/Cindy E Hayes 103 N Campbell Blvd State Parcel Number Legal Description Haubstadt IN 47639-8163 I I I I I I I I I I I I I I I I I I I I I o I 26-18-36-401-000.638-009 013-00638-00 WEST HGTS 4TH ADD 7 rn tars rot It u u nth t nn r r t PART 2:TAXPAYER INFORMATION Owner I First Middle Last J ol3rJ PTh-a c\_— \c\%-(E_- s _ _- _ tg Address(number std street,city,state,and ZIP code) — 4 Setae asproperty oddiess - — - _ -- Spouse First Middle Last Qindy Kleine ��tIHoye3 Mailin!Address(Number and street,city',state,and ZIP code) l,ir atme as property address • 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 PART 4:ADDITIONAL INFORMATION • •