Homestead_LyonlCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
I• State Form 5473 (R2 15-92)
INSTRUCTIONS: See reverse side for filing instructions.
FORM
HC10
YEAR
_1 CERTIFICATION STATEMENT �rl.
t,
I (We) c - s day of March, 19_
I (We) ied as our principal place of ence the following esc � d real . property for which a Ho s ead Property Tax predit is hereby claimed:
❑ 1 owned ❑ Are buyi under contract �f OV 2 2 11JJJJ
F-1 Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns a property oi$ buyin nd a contract.
CONTRACT RECORDED
If buying on contract, Fee Simple owners name -
Recorders office where contract is recorded
Record number
Page
PROPERTY DESCRIPTION
COUn
Township
Taw di c (c wn, town p)
Parcel number
Legal description
1?-
L 7J
If any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that structure is used toAfroduce intorne, describe dr use and portion of
the property utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
County
Township
County
Township
,--
Signature of claimant
reby certify the above statements are true, correct and complete.
dress (number and street. pry, state, ZIP code)
'�76 3ASSESSOR
oS S
USE ONLY
rLand
TRUE TAX
ASSESSED
HOMESTEAD
NON - RESIDENTIAL
VALUE
VALUE
VALUE
VALUE
not exceeding 1 (one) acre immediately
(1)
surrounding residential improvements.
Otherland
(2)
Total land (line I plus line 2)
(3)
Dwelling
(4)
Residential improvements
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(8)
1 hereby certify the above is true, correct, and
Signature of Assesor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19_ Pay 19
Lesser of 1/2 Homestead
S
Valuation or $2,000
Signature of Auditor
Date signed
SIATE FORM:Wis.O_(HY1 n flLASURIR PORN 79-IA
P .APPROVED BY CIVIL WIAO OF MY-YRNT,.1sw PArsmnmm BY 111E DEPARTo.TOF LL XI Alr OEGYMUNIFINANCEtc 41.1.E2.,.,
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 e'er for homestead frame Homestead fraud causes higher tax tills for all:therefore.
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to recene the
benefit and to pnavide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will be Lela mnfdeniial and can only he accessed by authorized county officials.The Department of
local Government finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taspaver Name Property Address
Lyon, John B/Janette
405 E Elm
Ilauhstadt IN 47639
8257
John B/Janette Lyon
405E Elm PO Box 405 State Parcel Number Legal Description
_ _ _Haubsladt IN 47639-0405- -
— — --° -- — 2619-3Y 304-000:200-009 ---013-00200-00 EPARK-ADD-450 PT/451-PT —
MJIIILIIlillool111111111111111,1118111111111111111111t.I II
PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
g.Address(number and street,city,state,and ZIP code) -- ❑ as property address - — - -
-Y t�x �k/.5 fk l k)S1-� dt- l 4P) G -3 cy
Spouse First Middle Last
lore No e c:) oiie1te c, n\
Mailing Address(Number and street,city,stale.and ZIP code) Same is property address
eC;X- -rC,) {\-1,Vi A=C-7— -gin)— — 13 — — — — — — — —
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 properly. 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
M.. /'n non/.1 . Aitet
PART 4:ADDITIONAL INFORMATION
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