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CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (R2 / 5-92)
INSTRUCTIONS: See reverse side for filing instructions.
FORM
HC10
YEAR
CERTIFICATION STATE T
I (We) e t e st day of March, 19_
I (We) occupied as our principal place of residence the following described real property for which a A= redit is hereby claimed:
❑ I (We) owned ❑ Are buying under contract tu� LL,�U1uO
❑ Have a beneficial interest in the entity that is liable for the property taxes on the property and that o s the prope buyin nd a contract.
T
CONTRACT RECORDED
COUPI
If buying on contract, Fee Simple owner's name r -
Recorder's office where contract is recorded
Record number
Page
PROPERTY DESCRIPTION
County
Township
Taxing district (city, town, township)
Parcel number
Legal desgotion
If any portion of the residential mcture or the land not exceeding on acre thift immediatety surrounds that structure is used to produce income, descnbe the use and portion of
the Property utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
County
Township
County
Township
®ereby certify the above statements are true, correct and complete.
ig cure of claimant
/ J
Add rem (number and street, city, state. ZIP code)
S 6.
ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON - RESIDENTIAL
VALUE
Land not exceeding I (one) acre immediately
surrounding residential improvements.
(1)
Otherland
(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 plus line 7)
(8)
I hereby certify the above is true, correct, and
complete.
Signature of Pssesor
Date signed
Vedtying action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19_ Pay 19
Lesser of 1/2 Homestead
Valuation or $2,000
$
Signature of Auditor
Date signed
NIUE I.ORM!!H12'IYNI M.NIfl TON 73-IA
APPROVED BY MATE ECKRD KAlTY1-NT5.!NS PRrSTIBm BY TIE OEP,kn NTOF LOLAHL GOVERNMENT FIwANCEMs1.1-raI
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY GWNERS
PRINCETON IN 47670 Individuals and married couples are limited to orlc homestead sundard deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive dun eser for homestead fraud.Ilomarearl fraud causes higher tax bills for all:therefore.
• HEA 1314-2009 requires taxpayers who receive the homestead standard deduction'to verify that they am eligible to receive the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.ibis information will he kept confidential and can only le accessed by authorized county officials.The Ikpanmem 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
Henico, Marland
306 Gibson ST
Ilaubstadt IN 47639
8214
Marland Henico
306 W Gibson State Parcel Number Legal Description
HAUBSTADT IN 47639-8132
26-19-31-303-000.315-009 013-00315-00 ORIGINAL PLAN 152 PT
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
N Joseph /tatXoo
Address(number and street,city,state,and ZIP code) —— -- -- 'Same ns prapertc Iddress — — .3062 W&Sf C-Z6S ( srEgrr, /-I4als4-ad/ , . ,J 74739
Spouse First Middle Last
Mailing Address(Number and street,city,state,and"LIP code) El 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)
sea
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 Sigma � Date
•