Homestead_Mayers,rr° CLAIM FOR HOMESTEAD PROPERTY TAX -
CREDIT /STANDARD DEDUCTION
State Form 5473 (82 15-92)
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INSTRUCTIONS: See reverse side for filing instructions.
FORM
HC10
FYEARl
FlCATION STATEMENT
I (We) - certify that on st y Mar ea
.' 'We pi as our principal a of residence t following describe eal property for which a Homestead Property resr aI
I (We) owned ❑ Are uying under contract
M�� y
Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is MA Yg @,, Or 490tact.
CONTRACT RECORDED
f y) 1
If buying on contract, Fee Simple owner's name I'"✓
GIBBON C'Oi,L`i i Y AUDIT09
Recorders office where contract is recorded
Record number
Page
PROPERTY DESCRIPTION
County Township
Taxing distri (d , to n, to ship)
ber O ^ _ �L Idescrption
If any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that structure is used to produce income, describe the use and portion of
the property utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
county Township
County Township
S' net of claimant
I hereby certify the above statements are true, correct and complete.
A M_1 r ffla
Address (number and street, city, state, ZIP code)
R 2 i5a 359 4&u.hsf LI-7b 3
ASSESSOR USE ONLY
TRUE TAX
ASSESSED
HOMESTEAD
NON - RESIDENTIAL
VALUE
VALUE
VALUE
VALUE
Land 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
$
Valuation or $2,000
Signature of Auditor
Date signed
M ATE FORM!MWI B:IVYI TRnASIIAfa FOAM TS-IA
.Ar/KM'ED BY ctMIL MsRD DE mr ,T%.bm PtrYABnD BY 711E DEPMnW.Vr OF LOCAL GOVEICNrNr FINANCE It' it -L.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:standard deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than erer for homestead fraud.Homestead fraud causes higher tai bills for all:therefore.
HEA 1344-7009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to retire the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will he kept confidential and can only he accessed by authorized county official..The Ikpannlent of
Local Government Finance will use this information to create touts that will hip county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION
Taxpayer Name Property Address
_ Mayer, Nancy A
413 S West
Ilaub:dad'IN 47639
9422
Nancy A Mayer
411 S West State Parcel Number Legal Description
Haubstadt IN 47639-8155
26-22-01-200-000.464-009 013-00464-D0 PT FR 1-4-11 .50 AC
IIIII�rI�IGurlia lul,11uiitiiulluGIuJulurrrllrtrilli—Dri-- _- —' -- ---- -- - — ._
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PART 2:TAXPAYER INFORMATION
Owner I First Middle Last Ai
A�rc�� A l�- frfiggie--
ling Address(number and street.city,state,and ZIP code) I^ I Same as property address - -
'+11 S . WEsr Sr .
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Pan 4 below)
s==
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.
OWDet 1 Si Date
PART 4:ADDITIONAL INFORMATION
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