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Homestead_Maurer0 } CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR CREDIT /STANDARD DEDUCTION HC10 14-03) State Form 5473 (Re 1IXi) Prescribed by the Department of Local Government Finance INSTRUCTIONS: See reverse side for filing inslnictions. I (We) �T /E'.. certify that on the 1 st day of March, 20��71ifi{iffI I (We) occupied as our principal place of residence the following described real property for which a Homestead Property Tax Credit�4lc�rebl j�imd113 Pri (We) owned ❑ Are buying under contract r Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or ip�buying urMer con ,;t.. <CONTRACT�RECORDED" r.ya .y „-'°= 4"'a'r ' .'•+�"r'e"ya -. _— If buying on contract, Fee Simple owners name Recorders office where contract is recorded Record number Page 20 _ Pay 20 _ Lesser of 112 Homestead Valuation or 535.000 Date signed PROP,ERT,Y DESCRIP. ON' ''� County Township T Intt (ti own, Township) I rturi76L�i n O I O {I C7/t v egal descnptio Is the property in qua ' . eel property ❑ Mobile Home (LC. 6f.1 -7) H any portion of the residential structure or the Land not exceeding one (1) acre that immediately surrounds th} t structure is used to produce income, describe the use and portion of the property utilized to produce income. / 70a / I 20 _ Pay 20 _ Lesser of 112 Homestead Valuation or 535.000 Date signed County County Township 1 hereby certify the above statements are true, correct and complete. Signature 901aimant. Address (number and t. fe, ZIP code) -s °.Y'xi:'ss' ''Y�' ASSESSOR�USE ONLY �,TRUETAX wVALUE� s, - ASSESSED VALUE"HOMESTEAD -AT 300 %OFZfV `VALUE nNON- ;RESIDENTIAL' ' 'VALUE Land not exceeding 1 (one) acre immediatelys surrounding residential improvements. (1)sr Other land 2��rs�,- - '~!•�:ss`��'`' Total land (line 1 plus line 2) (3) Residential improvements or Annually Assessed Mobile/ Manufactured Hoare Dwelling Garage (4)`- e sz `pz r '01 p'fl` ;,, •� '-�* • - ' + ^`: . Other improvements (6) I�'; Total improvements (line 4 through line 6) (7) Total value (line 3 plus line 7) (6) 1 hereby certify the above is We, correct, and complete. Signature of Assessor Date signed Verifying action - Signature of Auditor Date signed 20 _ Pay 20 _ Lesser of 112 Homestead Valuation or 535.000 Date signed sure11*51 YN,R:tn-rn • TIASUIUR roam it-TA APPROVED by SI kit M'Rn INMYT 11 2P PUS1UMDBY 111E DFPARTxn,T(�F LOCAL rswetNnrNT!NA CErC Vet"-Rt Gibson County Auditor 101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS PRINCETON IN 47670 Individual and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes more beneficial,there is more incentive than e'er 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 are eligible to receive the benefit and to provide additional identifying information necessary to allow county government to better monitor homestead flings.this information will be kept confidential and can only be accessed by authorized county officials.The Depanmem of Local Government Finance will toe this information to create nuts that will help county officials eliminate homestead fraud. PART 1: PROPERTY INFORMATION Taxpayer Name Properh*Address Maurer, Lillian Trust 116 S Vonna I.N Haubstadt IN 47639 7347 Lillian Maurer 116 Vonna Lane State Parcel Number Lesal Description HAUBSTADT IN 47639-8131 �t�tt��trt�r��rtt r��r�r�rr�rt�tttt��tt��t tit��rtr��r��tttrr��� 26-18-36-403-000.316-009 013-00316-00 WEST HGTS 2ND ADD 702 PART 2: TAXPAYER INFORMATION Owner I First �S Middle Last - • - • ig Address(number and street.city,state,and ZIP code) 0-Same as property address - - - -- /i /� jeLa,otiatev Spouse First Middle Last Mailing Address(Number and street.city,state,and ZIP code) Same as propene address Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below) sme PART 3:CERTIFICATION Each undersigned certifies,under penalty of perjury.that the above and foregoing information is tale 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 n,, Dare •